Mass spectrometry of steroidal compounds in multiplexed patient samples

ABSTRACT

The invention relates to the quantitative measurement of steroidal compounds by mass spectrometry. In a particular aspect, the invention relates to methods for quantitative measurement of steroidal compounds from multiple samples by mass spectrometry.

FIELD OF THE INVENTION

The invention relates to the quantitative measurement of steroidalcompounds by mass spectrometry. In a particular aspect, the inventionrelates to methods for quantitative measurement of steroidal compoundsfrom multiple samples by mass spectrometry.

BACKGROUND OF THE INVENTION

Steroidal compounds are any of numerous naturally occurring or syntheticfat-soluble organic compounds having as a basis 17 carbon atoms arrangedin four rings and including the sterols and bile acids, adrenal and sexhormones, certain natural drugs such as digitalis compounds, as well ascertain vitamins and related compounds (such as vitamin D, vitamin Danalogues, and vitamin D metabolites).

Many steroidal compounds are biologically important. For example,vitamin D is an essential nutrient with important physiological roles inthe positive regulation of calcium (Ca²⁺) homeostasis. Vitamin D can bemade de novo in the skin by exposure to sunlight or it can be absorbedfrom the diet. There are two forms of vitamin D; vitamin D₂(ergocalciferol) and vitamin D₃ (cholecalciferol). Vitamin D₃ is theform synthesized de novo by animals. It is also a common supplementadded to milk products and certain food products produced in the UnitedStates. Both dietary and intrinsically synthesized vitamin D₃ mustundergo metabolic activation to generate the bioactive metabolites. Inhumans, the initial step of vitamin D₃ activation occurs primarily inthe liver and involves hydroxylation to form the intermediate metabolite25-hydroxycholecalciferol (calcifediol; 25OHD₃). Calcifediol is themajor form of Vitamin D₃ in circulation. Circulating 25OHD₃ is thenconverted by the kidney to form 1,25-dihydroxyvitamin D₃ (calcitriol;1,25(OH)₂D₃), which is generally believed to be the metabolite ofVitamin D₃ with the highest biological activity.

Vitamin D₂ is derived from fungal and plant sources. Manyover-the-counter dietary supplements contain ergocalciferol (vitamin D₂)rather than cholecalciferol (vitamin D₃). Drisdol, the only high-potencyprescription form of vitamin D available in the United States, isformulated with ergocalciferol. Vitamin D₂ undergoes a similar pathwayof metabolic activation in humans as Vitamin D₃, forming the metabolites25OHD₂ and 1,25(OH)₂D₂. Vitamin D₂ and vitamin D₃ have long been assumedto be biologically equivalent in humans, however recent reports suggestthat there may be differences in the bioactivity and bioavailability ofthese two forms of vitamin D (Armas et. al., (2004) J. Clin. Endocrinol.Metab. 89:5387-5391).

Measurement of vitamin D, the inactive vitamin D precursor, is rare inclinical settings. Rather, serum levels of 25-hydroxyvitamin D₃,25-hydroxyvitamin D₂, and total 25-hydroxyvitamin D (“25OHD”) are usefulindices of vitamin D nutritional status and the efficacy of certainvitamin D analogs. The measurement of 25OHD is commonly used in thediagnosis and management of disorders of calcium metabolism. In thisrespect, low levels of 25OHD are indicative of vitamin D deficiencyassociated with diseases such as hypocalcemia, hypophosphatemia,secondary hyperparathyroidism, elevated alkaline phosphatase,osteomalacia in adults and rickets in children. In patients suspected ofvitamin D intoxication, elevated levels of 25OHD distinguishes thisdisorder from other disorders that cause hypercalcemia.

Measurement of 1,25(OH)₂D is also used in clinical settings. Certaindisease states can be reflected by circulating levels of 1,25(OH)₂D, forexample kidney disease and kidney failure often result in low levels of1,25(OH)₂D. Elevated levels of 1,25(OH)₂D may be indicative of excessparathyroid hormone or can be indicative of certain diseases such assarcoidosis or certain types of lymphomas.

Detection of vitamin D metabolites has been accomplished byradioimmunoassay with antibodies co-specific for 25OHD₂ and 25OHD₃.Because the current immunologically-based assays do not separatelyresolve 25OHD₂ and 25OHD₃, the source of any nutritional deficiency ofvitamin D cannot be determined without resorting to other tests. Reportshave been published that disclose methods for detecting specific vitaminD metabolites using mass spectrometry. In some of the reports, thevitamin D metabolites are derivatized prior to mass spectrometry, but inothers, they are not. For example Holmquist, et al., U.S. patentapplication Ser. No. 11/946,765, filed Dec. 28, 2007; Yeung B, et al., JChromatogr. 1993, 645(1):115-23; Higashi T, et al., Steroids. 2000,65(5):281-94; Higashi T, et al., Biol Pharm Bull. 2001, 24(7):738-43;Higashi T, et al., J Pharm Biomed Anal. 2002, 29(5):947-55; Higashi T,et al., Anal. Bioanal Chem, 2008, 391:229-38; and Aronov, et al., AnalBioanal Chem, 2008, 391:1917-30 disclose methods for detecting variousvitamin D metabolites by derivatizing the metabolites prior to massspectrometry. Methods to detect underivatized vitamin D metabolites arereported in Clarke, et al., in U.S. patent application Ser. Nos.11/101,166, filed Apr. 6, 2005, and 11/386,215, filed Mar. 21, 2006, andSingh, et al., in U.S. patent application Ser. No. 10/977,121, filedOct. 24, 2004. Reports have also been published that disclosederivatization of vitamin D₃ with Cookson-type reagents, specifically4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) and4-[2-(6,7-dimethoxy-4-methyl-3-oxo-3,4-dihydroquinoxalyl)ethyl]-1,2,4-triazoline-3,5-dione(DMEQ-TAD). See Aberhart, J, et al., J. Org. Chem. 1976,41(12):2098-2102, and Kamao, M, et al., J Chromatogr. B 2007,859:192-200.

SUMMARY OF THE INVENTION

The present invention provides methods for detecting the amount of asteroidal compound in each of a plurality of test samples with a singlemass spectrometric assay. The methods include processing each testsample differently to form a plurality of processed samples, wherein asa result of the processing, the steroidal compound in each processedsample is distinguishable by mass spectrometry from the steroidalcompound in other processed samples; combining the processed samples toform a multiplex sample; subjecting the multiplex sample to anionization source under conditions suitable to generate one or more ionsdetectable by mass spectrometry, wherein one or more ions generated fromthe steroidal compound from each processed sample are distinct from oneor more ions from the steroidal compound from the other processedsamples; detecting the amount of one or more ions from the steroidalcompound from each processed sample by mass spectrometry; and relatingthe amount of one or more ions from the steroidal compound from eachprocessed sample to the amount of the steroidal compound in each testsample.

In some embodiments, processing a test sample comprises subjecting eachtest sample to a different derivatizing agent under conditions suitableto generate derivatized steroidal compounds. In some embodiment, onetest sample may be processed without subjecting the sample to aderivatizing agent.

In some embodiments, the different derivatizing agents used in theprocessing of the plurality of test samples are isotopic variants ofeach another. In some embodiments, the different derivatizing agents areCookson-type derivatizing agents; such as Cookson-type derivatizationagents selected from the group consisting of4-phenyl-1,2,4-triazoline-3,5-dione (PTAD),4-[2-(6,7-dimethoxy-4-methyl-3-oxo-3,4-dihydroquinoxalyl)ethyl]-1,2,4-triazoline-3,5-dione(DMEQTAD), 4-(4-nitrophenyl)-1,2,4-triazoline-3,5-dione (NPTAD),4-ferrocenylmethyl-1,2,4-triazoline-3,5-dione (FMTAD), and isotopicvariants thereof. In one related embodiment, the Cookson-typederivatizing agents are isotopic variants of4-phenyl-1,2,4-triazoline-3,5-dione (PTAD). In a specific embodiment,the plurality of samples comprises two samples, a first Cookson-typederivatizing reagent is 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD), anda second Cookson-type derivatizing reagent is¹³C₆-4-phenyl-1,2,4-triazoline-3,5-dione (¹³C₆-PTAD).

In some embodiments, the steroidal compound is a vitamin D or vitamin Drelated compound. In related embodiments, the steroidal compound isselected from the group consisting of vitamin D₂, vitamin D₃,25-hydroxyvitamin D₂ (25OHD₂), 25-hydroxyvitamin D₃ (25OHD₃),1α,25-dihydroxyvitamin D₂ (1α,25OHD₂), and 1α,25-dihydroxyvitamin D₃(1α,25OHD₃). In a specific embodiment, the steroidal compound is25-hydroxyvitamin D₂ (25OHD₂) or 25-hydroxyvitamin D₃ (25OHD₃).

The methods described above may be conducted for the analysis of two ormore steroidal compounds in each of a plurality of test samples. In someof these embodiments, the two or more steroidal compounds in each testsample may include at least one steroidal compound selected from thegroup consisting of 25-hydroxyvitamin D₂ (25OHD₂) and 25-hydroxyvitaminD₃ (25OHD₃). In some embodiments, the two or more steroidal compounds ineach test sample are 25-hydroxyvitamin D₂ (25OHD₂) and 25-hydroxyvitaminD₃ (25OHD₃).

In specific embodiments, the amount of one or more vitamin D or vitaminD related compounds in each of two test samples is determined with asingle mass spectrometric assay. In this embodiment, a first processedsample is generated by subjecting a first test sample to a firstisotopic variant of 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) underconditions suitable to generate one or more vitamin D or vitamin Drelated derivatives; a second processed sample is generated bysubjecting a second test sample to a second isotopic variant of4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) under conditions suitable togenerate one or more vitamin D or vitamin D related derivatives, whereinthe first and second isotopic variant of PTAD are distinguishable bymass spectrometry; the first processed sample is mixed with the secondprocessed sample to form a multiplex sample; one or more vitamin D orvitamin D related derivatives from each processed sample in themultiplex sample are subjected to an ionization source under conditionssuitable to generate one or more ions detectable by mass spectrometry,wherein one or more ions from each vitamin D or vitamin D relatedderivatives from the first processed sample are distinct from the one ormore ions from vitamin D or vitamin D related derivatives from thesecond processed sample; the amounts of one or more ions from one ormore vitamin D or vitamin D related derivatives from each processedsample are determined by mass spectrometry; and the amounts of thedetermined ions are related to the amounts of vitamin D or vitamin Drelated compound in the first or second test sample.

In some specific embodiments, the first isotopic variant of4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) is4-phenyl-1,2,4-triazoline-3,5-dione (PTAD), and the second isotopicvariant of 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) is¹³C₆-4-phenyl-1,2,4-triazoline-3,5-dione (¹³C₆-PTAD).

In some specific embodiments, the one or more vitamin D or vitamin Drelated compounds are selected from the group consisting of25-hydroxyvitamin D₂ (25OHD₂) and 25-hydroxyvitamin D₃ (25OHD₃). In somerelated specific embodiments, the one or more vitamin D or vitamin Drelated compounds include 25-hydroxyvitamin D₂ (25OHD₂) and25-hydroxyvitamin D₃ (25OHD₃). In some related specific embodiments, theone or more vitamin D or vitamin D related compounds are25-hydroxyvitamin D₂ (25OHD₂) and 25-hydroxyvitamin D₃ (25OHD₃).

In some embodiments, the multiplex sample is subjected to an extractioncolumn and an analytical column prior to being subjected to anionization source. In some related embodiments, the extraction column isa solid-phase extraction (SPE) column. In other related embodiments, theextraction column is a turbulent flow liquid chromatography (TFLC)column. In some embodiments, the analytical column is a high performanceliquid chromatography (HPLC) column.

In embodiments which utilize two or more of an extraction column, ananalytical column, and an ionization source, two or more of thesecomponents may be connected in an on-line fashion to allow for automatedsample processing and analysis.

In the methods described herein, mass spectrometry may be tandem massspectrometry. In embodiments utilizing tandem mass spectrometry, tandemmass spectrometry may be conducted by any method known in the art,including for example, multiple reaction monitoring, precursor ionscanning, or product ion scanning.

In the methods described herein, steroidal compounds may be ionized byany suitable ionization technique known in the art. In some embodiments,the ionization source is a laser diode thermal desorption (LDTD)ionization source.

In preferred embodiments, the test samples comprise biological samples,such as plasma or serum.

As used herein, the term “multiplex sample” refers to a sample preparedby pooling two or more samples to form the single “multiplex” samplewhich is then subject to mass spectrometric analysis. In the methodsdescribed herein, two or more test samples are each processeddifferently to generate multiple differently processed samples. Thesemultiple differently processed samples are then pooled to generate asingle “multiplex” sample, which is then subject to mass spectrometricanalysis.

As used herein, the term “steroidal compound” refers to any of numerousnaturally occurring or synthetic fat-soluble organic compounds having asa basis 17 carbon atoms arranged in four rings and including the sterolsand bile acids, adrenal and sex hormones, certain natural drugs such asdigitalis compounds, as well as certain vitamins and related compounds(such as vitamin D, vitamin D analogues, and vitamin D metabolites).

As used herein, the term “vitamin D or vitamin D related compound”refers to any natural or synthetic form of vitamin D, or any chemicalspecies related to vitamin D generated by a transformation of vitamin D,such as intermediates and products of vitamin D metabolism. For example,vitamin D may refer to one or more of vitamin D₂ and vitamin D₃. VitaminD may also be referred to as “nutritional” vitamin D to distinguish fromchemical species generated by a transformation of vitamin D. Vitamin Drelated compounds may include chemical species generated bybiotransformation of analogs of, or a chemical species related to,vitamin D₂ or vitamin D₃. Vitamin D related compounds, specificallyvitamin D metabolites, may be found in the circulation of an animaland/or may be generated by a biological organism, such as an animal.Vitamin D metabolites may be metabolites of naturally occurring forms ofvitamin D or may be metabolites of synthetic vitamin D analogs. Incertain embodiments, vitamin D related compounds may include one or morevitamin D metabolites selected from the group consisting of25-hydroxyvitamin D₃, 25-hydroxyvitamin D₂, 1α,25-dihydroxyvitamin D₃and 1α,25-dihydroxyvitamin D₂.

As used herein, “derivatizing” means reacting two molecules to form anew molecule. Thus, a derivatizing agent is an agent that is reactedwith another substance to derivatize the substance. For example,4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) is a derivatizing reagentthat may be reacted with a vitamin D metabolite to form aPTAD-derivatized vitamin D metabolite.

As used herein, “different derivatizing agents” are derivatizing agentsthat are distinguishable by mass spectrometry. As one example, twoisotopic variants of the same derivatizing agent are distinguishable bymass spectrometry. As another example, halogenated variants of the samederivatizing agent are also distinguishable by mass spectrometry. Forexample, halogenated and non-halogenated versions of the sameCookson-type agent, such as 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD),may be used. Further, two halogenated versions of the same Cookson-typeagent, but halogenated with different halogens or with different numbersof halogens, may be used. As another example, two different Cookson-typeagents, such as 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD),4-methyl-1,2,4-triazoline-3,5-dione (MTAD), and4-(4-nitrophenyl)-1,2,4-triazoline-3,5-dione (NPTAD), may be used. Theabove examples illustrate the principle of derivatizing agents that aredistinguishable by mass spectrometry. Other examples, includingcombinations of any of the above, may be possible as would beappreciated by one of skill in the art.

As used herein, the names of derivatized forms of steroidal compoundsinclude an indication as to the nature of derivatization. For example,the PTAD derivative of 25-hydroxyvitamin D₂ is indicated asPTAD-25-hydroxyvitamin D₂ (or PTAD-25OHD₂).

As used herein, a “Cookson-type derivatizing agent” is a 4-substituted1,2,4-triazoline-3,5-dione compound. Exemplary Cookson-type derivatizingagents include 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD),4-methyl-1,2,4-triazoline-3,5-dione (MTAD),4-[2-(6,7-dimethoxy-4-methyl-3-oxo-3,4-dihydroquinoxalyl)ethyl]-1,2,4-triazoline-3,5-dione(DMEQTAD), 4-(4-nitrophenyl)-1,2,4-triazoline-3,5-dione (NPTAD), and4-ferrocenylmethyl-1,2,4-triazoline-3,5-dione (FMTAD). Additionally,isotopically labeled variants of Cookson-type derivatizing agents may beused in some embodiments. For example, the ¹³C₆-PTAD isotopic variant is6 mass units heavier than normal PTAD and may be used in someembodiments. Derivatization of steroidal compounds, including vitamin Dand vitamin D related compounds, by Cookson-type reagents can beconducted by any appropriate method. See, e.g., Holmquist, et al., U.S.patent application Ser. No. 11/946,765, filed Dec. 28, 2007; Yeung B, etal., J Chromatogr. 1993, 645(1):115-23; Higashi T, et al., Steroids.2000, 65(5):281-94; Higashi T, et al., Biol Pharm Bull. 2001,24(7):738-43; Higashi T, et al., J Pharm Biomed Anal. 2002,29(5):947-55; Higashi T, et al., Anal. Biochanal Chem, 2008, 391:229-38;and Aronov, et al., Anal Bioanal Chem, 2008, 391:1917-30.

In certain preferred embodiments of the methods disclosed herein, massspectrometry is performed in positive ion mode. Alternatively, massspectrometry is performed in negative ion mode. Various ionizationsources, including for example atmospheric pressure chemical ionization(APCI) or electrospray ionization (ESI), may be used in embodiments ofthe present invention. In certain embodiments, steroidal compounds,including vitamin D and vitamin D related compounds, are measured usingAPCI in positive ion mode.

In preferred embodiments, one or more separately detectable internalstandards are provided in the sample, the amount of which are alsodetermined in the sample. In these embodiments, all or a portion of boththe analyte(s) of interest and the internal standard(s) present in thesample are ionized to produce a plurality of ions detectable in a massspectrometer, and one or more ions produced from each are detected bymass spectrometry. Exemplary internal standard(s) include vitamin D₂-[6,19, 19]-²H₃, vitamin D₂-[24, 24, 24, 25, 25, 25]-²H₆, vitamin D₃-[6, 19,19]-²H₃, vitamin D₃-[24, 24, 24, 25, 25, 25]-²H₆, 25OHD₂-[6, 19,19]-²H₃, 25OHD₂-[24, 24, 24, 25, 25, 25]-²H₆, 25OHD₃-[6, 19, 19]-²H₃,25OHD₃-[24, 24, 24, 25, 25, 25]-²H₆, 1α,25OHD₂-[6, 19, 19]-²H₃,1α,25OHD₂-[24, 24, 24, 25, 25, 25]-²H₆, 1α,25OHD₃-[6, 19, 19]-²H₃,1α,25OHD₃-[24, 24, 24, 25, 25, 25]-²H₆.

One or more separately detectable internal standards may be provided inthe sample prior to treatment of the sample with a Cookson-typederivatizing reagent. In these embodiments, the one or more internalstandards may undergo derivatization along with the endogenous steroidalcompounds, in which case ions of the derivatized internal standards aredetected by mass spectrometry. In these embodiments, the presence oramount of ions generated from the analyte of interest may be related tothe presence of amount of analyte of interest in the sample. In someembodiments, the internal standards may be isotopically labeled versionsof steroidal compounds under investigation. For example in an assaywhere vitamin D metabolites are analytes of interest, 25OHD₂-[6, 19,19]-²H₃ or 25OHD₃-[6, 19, 19]-²H₃ may be used as an internal standard.In embodiments where 25OHD₂-[6, 19, 19]-²H₃ is used as internalstandards, PTAD-25OHD₂-[6, 19, 19]-²H₃ ions detectable in a massspectrometer are selected from the group consisting of positive ionswith a mass/charge ratio (m/z) of 573.30±0.50 and 301.10±0.50. Inrelated embodiments, a PTAD-25OHD₂-[6, 19, 19]-²H₃ precursor ion has am/z of 573.30±0.50, and a fragment ion has m/z of 301.10±0.50. Inembodiments where 25OHD₃-[6, 19, 19]-²H₃ is used as an internalstandard, PTAD-25OHD₃-[6, 19, 19] ions detectable in a mass spectrometerare selected from the group consisting of positive ions with amass/charge ratio (m/z) of 561.30±0.50 and 301.10±0.50. In relatedembodiments, a PTAD-25OHD₃-[6, 19, 19] precursor ion has a m/z of561.30±0.50, and a fragment ion has m/z of 301.10±0.50.

As used herein, an “isotopic label” produces a mass shift in the labeledmolecule relative to the unlabeled molecule when analyzed by massspectrometric techniques. Examples of suitable labels include deuterium(²H), ¹³C, and ¹⁵N. For example, 25OHD₂-[6, 19, 19] and 25OHD₃-[6, 19,19] have masses about 3 mass units higher than 25OHD₂ and 25OHD₃. Theisotopic label can be incorporated at one or more positions in themolecule and one or more kinds of isotopic labels can be used on thesame isotopically labeled molecule.

In other embodiments, the amount of the vitamin D metabolite ion or ionsmay be determined by comparison to one or more external referencestandards. Exemplary external reference standards include blank plasmaor serum spiked with one or more of 25OHD₂, 25OHD₂-[6, 19, 19], 25OHD₃,and 25OHD₃-[6, 19, 19]. External standards typically will undergo thesame treatment and analysis as any other sample to be analyzed,including treatment with one or more Cookson-type reagents prior to massspectrometry.

In certain preferred embodiments, the limit of quantitation (LOQ) of25OHD₂ is within the range of 1.9 ng/mL to 10 ng/mL, inclusive;preferably within the range of 1.9 ng/mL to 5 ng/mL, inclusive;preferably about 1.9 ng/mL. In certain preferred embodiments, the limitof quantitation (LOQ) of 25OHD₃ is within the range of 3.3 ng/mL to 10ng/mL, inclusive; preferably within the range of 3.3 ng/mL to 5 ng/mL,inclusive; preferably about 3.3 ng/mL.

As used herein, unless otherwise stated, the singular forms “a,” “an,”and “the” include plural reference. Thus, for example, a reference to “aprotein” includes a plurality of protein molecules.

As used herein, the term “purification” or “purifying” does not refer toremoving all materials from the sample other than the analyte(s) ofinterest. Instead, purification refers to a procedure that enriches theamount of one or more analytes of interest relative to other componentsin the sample that may interfere with detection of the analyte ofinterest. Purification of the sample by various means may allow relativereduction of one or more interfering substances, e.g., one or moresubstances that may or may not interfere with the detection of selectedparent or daughter ions by mass spectrometry. Relative reduction as thisterm is used does not require that any substance, present with theanalyte of interest in the material to be purified, is entirely removedby purification.

As used herein, the term “solid phase extraction” or “SPE” refers to aprocess in which a chemical mixture is separated into components as aresult of the affinity of components dissolved or suspended in asolution (i.e., mobile phase) for a solid through or around which thesolution is passed (i.e., solid phase). In some instances, as the mobilephase passes through or around the solid phase, undesired components ofthe mobile phase may be retained by the solid phase resulting in apurification of the analyte in the mobile phase. In other instances, theanalyte may be retained by the solid phase, allowing undesiredcomponents of the mobile phase to pass through or around the solidphase. In these instances, a second mobile phase is then used to elutethe retained analyte off of the solid phase for further processing oranalysis. SPE, including TFLC, may operate via a unitary or mixed modemechanism. Mixed mode mechanisms utilize ion exchange and hydrophobicretention in the same column; for example, the solid phase of amixed-mode SPE column may exhibit strong anion exchange and hydrophobicretention; or may exhibit column exhibit strong cation exchange andhydrophobic retention.

As used herein, the term “chromatography” refers to a process in which achemical mixture carried by a liquid or gas is separated into componentsas a result of differential distribution of the chemical entities asthey flow around or over a stationary liquid or solid phase.

As used herein, the term “liquid chromatography” or “LC” means a processof selective retardation of one or more components of a fluid solutionas the fluid uniformly percolates through a column of a finely dividedsubstance, or through capillary passageways. The retardation resultsfrom the distribution of the components of the mixture between one ormore stationary phases and the bulk fluid, (i.e., mobile phase), as thisfluid moves relative to the stationary phase(s). Examples of “liquidchromatography” include reverse phase liquid chromatography (RPLC), highperformance liquid chromatography (HPLC), and turbulent flow liquidchromatography (TFLC) (sometimes known as high turbulence liquidchromatography (HTLC) or high throughput liquid chromatography).

As used herein, the term “high performance liquid chromatography” or“HPLC” (sometimes known as “high pressure liquid chromatography”) refersto liquid chromatography in which the degree of separation is increasedby forcing the mobile phase under pressure through a stationary phase,typically a densely packed column.

As used herein, the term “turbulent flow liquid chromatography” or“TFLC” (sometimes known as high turbulence liquid chromatography or highthroughput liquid chromatography) refers to a form of chromatographythat utilizes turbulent flow of the material being assayed through thecolumn packing as the basis for performing the separation. TFLC has beenapplied in the preparation of samples containing two unnamed drugs priorto analysis by mass spectrometry. See, e.g., Zimmer et al., J ChromatogrA 854: 23-35 (1999); see also, U.S. Pat. Nos. 5,968,367, 5,919,368,5,795,469, and 5,772,874, which further explain TFLC. Persons ofordinary skill in the art understand “turbulent flow”. When fluid flowsslowly and smoothly, the flow is called “laminar flow”. For example,fluid moving through an HPLC column at low flow rates is laminar. Inlaminar flow the motion of the particles of fluid is orderly withparticles moving generally in straight lines. At faster velocities, theinertia of the water overcomes fluid frictional forces and turbulentflow results. Fluid not in contact with the irregular boundary “outruns”that which is slowed by friction or deflected by an uneven surface. Whena fluid is flowing turbulently, it flows in eddies and whirls (orvortices), with more “drag” than when the flow is laminar. Manyreferences are available for assisting in determining when fluid flow islaminar or turbulent (e.g., Turbulent Flow Analysis: Measurement andPrediction, P. S. Bernard & J. M. Wallace, John Wiley & Sons, Inc.,(2000); An Introduction to Turbulent Flow, Jean Mathieu & Julian Scott,Cambridge University Press (2001)).

As used herein, the term “gas chromatography” or “GC” refers tochromatography in which the sample mixture is vaporized and injectedinto a stream of carrier gas (as nitrogen or helium) moving through acolumn containing a stationary phase composed of a liquid or aparticulate solid and is separated into its component compoundsaccording to the affinity of the compounds for the stationary phase.

As used herein, the term “large particle column” or “extraction column”refers to a chromatography column containing an average particlediameter greater than about 50 μm.

As used herein, the term “analytical column” refers to a chromatographycolumn having sufficient chromatographic plates to effect a separationof materials in a sample that elute from the column sufficient to allowa determination of the presence or amount of an analyte. In a preferredembodiment the analytical column contains particles of about 5 μm indiameter. Such columns are often distinguished from “extractioncolumns”, which have the general purpose of separating or extractingretained material from non-retained materials in order to obtain apurified sample for further analysis.

As used herein, the terms “on-line” and “inline”, for example as used in“on-line automated fashion” or “on-line extraction” refers to aprocedure performed without the need for operator intervention. Incontrast, the term “off-line” as used herein refers to a procedurerequiring manual intervention of an operator. Thus, if samples aresubjected to precipitation, and the supernatants are then manuallyloaded into an autosampler, the precipitation and loading steps areoff-line from the subsequent steps. In various embodiments of themethods, one or more steps may be performed in an on-line automatedfashion.

As used herein, the term “mass spectrometry” or “MS” refers to ananalytical technique to identify compounds by their mass. MS refers tomethods of filtering, detecting, and measuring ions based on theirmass-to-charge ratio, or “m/z”. MS technology generally includes (1)ionizing the compounds to form charged compounds; and (2) detecting themolecular weight of the charged compounds and calculating amass-to-charge ratio. The compounds may be ionized and detected by anysuitable means. A “mass spectrometer” generally includes an ionizer andan ion detector. In general, one or more molecules of interest areionized, and the ions are subsequently introduced into a massspectrometric instrument where, due to a combination of magnetic andelectric fields, the ions follow a path in space that is dependent uponmass (“m”) and charge (“z”). See, e.g., U.S. Pat. Nos. 6,204,500,entitled “Mass Spectrometry From Surfaces;” 6,107,623, entitled “Methodsand Apparatus for Tandem Mass Spectrometry;” 6,268,144, entitled “DNADiagnostics Based On Mass Spectrometry;” 6,124,137, entitled“Surface-Enhanced Photolabile Attachment And Release For Desorption AndDetection Of Analytes;” Wright et al., Prostate Cancer and ProstaticDiseases 1999, 2: 264-76; and Merchant and Weinberger, Electrophoresis2000, 21: 1164-67.

As used herein, the term “operating in negative ion mode” refers tothose mass spectrometry methods where negative ions are generated anddetected. The term “operating in positive ion mode” as used herein,refers to those mass spectrometry methods where positive ions aregenerated and detected.

As used herein, the term “ionization” or “ionizing” refers to theprocess of generating an analyte ion having a net electrical chargeequal to one or more electron units. Negative ions are those having anet negative charge of one or more electron units, while positive ionsare those having a net positive charge of one or more electron units.

As used herein, the term “electron ionization” or “EI” refers to methodsin which an analyte of interest in a gaseous or vapor phase interactswith a flow of electrons. Impact of the electrons with the analyteproduces analyte ions, which may then be subjected to a massspectrometry technique.

As used herein, the term “chemical ionization” or “CI” refers to methodsin which a reagent gas (e.g. ammonia) is subjected to electron impact,and analyte ions are formed by the interaction of reagent gas ions andanalyte molecules.

As used herein, the term “fast atom bombardment” or “FAB” refers tomethods in which a beam of high energy atoms (often Xe or Ar) impacts anon-volatile sample, desorbing and ionizing molecules contained in thesample. Test samples are dissolved in a viscous liquid matrix such asglycerol, thioglycerol, m-nitrobenzyl alcohol, 18-crown-6 crown ether,2-nitrophenyloctyl ether, sulfolane, diethanolamine, andtriethanolamine. The choice of an appropriate matrix for a compound orsample is an empirical process.

As used herein, the term “matrix-assisted laser desorption ionization”or “MALDI” refers to methods in which a non-volatile sample is exposedto laser irradiation, which desorbs and ionizes analytes in the sampleby various ionization pathways, including photo-ionization, protonation,deprotonation, and cluster decay. For MALDI, the sample is mixed with anenergy-absorbing matrix, which facilitates desorption of analytemolecules.

As used herein, the term “surface enhanced laser desorption ionization”or “SELDI” refers to another method in which a non-volatile sample isexposed to laser irradiation, which desorbs and ionizes analytes in thesample by various ionization pathways, including photo-ionization,protonation, deprotonation, and cluster decay. For SELDI, the sample istypically bound to a surface that preferentially retains one or moreanalytes of interest. As in MALDI, this process may also employ anenergy-absorbing material to facilitate ionization.

As used herein, the term “electrospray ionization” or “ESI,” refers tomethods in which a solution is passed along a short length of capillarytube, to the end of which is applied a high positive or negativeelectric potential. Solution reaching the end of the tube is vaporized(nebulized) into a jet or spray of very small droplets of solution insolvent vapor. This mist of droplets flows through an evaporationchamber, which is heated slightly to prevent condensation and toevaporate solvent. As the droplets get smaller the electrical surfacecharge density increases until such time that the natural repulsionbetween like charges causes ions as well as neutral molecules to bereleased.

As used herein, the term “atmospheric pressure chemical ionization” or“APCI,” refers to mass spectrometry methods that are similar to ESI;however, APCI produces ions by ion-molecule reactions that occur withina plasma at atmospheric pressure. The plasma is maintained by anelectric discharge between the spray capillary and a counter electrode.Then ions are typically extracted into the mass analyzer by use of a setof differentially pumped skimmer stages. A counterflow of dry andpreheated N₂ gas may be used to improve removal of solvent. Thegas-phase ionization in APCI can be more effective than ESI foranalyzing less-polar species.

The term “atmospheric pressure photoionization” or “APPI” as used hereinrefers to the form of mass spectrometry where the mechanism for thephotoionization of molecule M is photon absorption and electron ejectionto form the molecular ion M+. Because the photon energy typically isjust above the ionization potential, the molecular ion is lesssusceptible to dissociation. In many cases it may be possible to analyzesamples without the need for chromatography, thus saving significanttime and expense. In the presence of water vapor or protic solvents, themolecular ion can extract H to form MH+. This tends to occur if M has ahigh proton affinity. This does not affect quantitation accuracy becausethe sum of M+ and MH+ is constant. Drug compounds in protic solvents areusually observed as MH+, whereas nonpolar compounds such as naphthaleneor testosterone usually form M+. See, e.g., Robb et al., Anal. Chem.2000, 72(15): 3653-3659.

As used herein, the term “inductively coupled plasma” or “ICP” refers tomethods in which a sample interacts with a partially ionized gas at asufficiently high temperature such that most elements are atomized andionized.

As used herein, the term “field desorption” refers to methods in which anon-volatile test sample is placed on an ionization surface, and anintense electric field is used to generate analyte ions.

As used herein, the term “desorption” refers to the removal of ananalyte from a surface and/or the entry of an analyte into a gaseousphase. Laser diode thermal desorption (LDTD) is a technique wherein asample containing the analyte is thermally desorbed into the gas phaseby a laser pulse. The laser hits the back of a specially made 96-wellplate with a metal base. The laser pulse heats the base and the heatcauses the sample to transfer into the gas phase. The gas phase sampleis then drawn into an ionization source, where the gas phase sample isionized in preparation for analysis in the mass spectrometer. When usingLDTD, ionization of the gas phase sample may be accomplished by anysuitable technique known in the art, such as by ionization with a coronadischarge (for example by APCI).

As used herein, the term “selective ion monitoring” is a detection modefor a mass spectrometric instrument in which only ions within arelatively narrow mass range, typically about one mass unit, aredetected.

As used herein, “multiple reaction mode,” sometimes known as “selectedreaction monitoring,” is a detection mode for a mass spectrometricinstrument in which a precursor ion and one or more fragment ions areselectively detected.

As used herein, the term “lower limit of quantification”, “lower limitof quantitation” or “LLOQ” refers to the point where measurements becomequantitatively meaningful. The analyte response at this LOQ isidentifiable, discrete and reproducible with a relative standarddeviation (RSD %) of less than 20% and an accuracy of 80% to 120%.

As used herein, the term “limit of detection” or “LOD” is the point atwhich the measured value is larger than the uncertainty associated withit. The LOD is the point at which a value is beyond the uncertaintyassociated with its measurement and is defined as three times the RSD ofthe mean at the zero concentration.

As used herein, an “amount” of an analyte in a body fluid sample refersgenerally to an absolute value reflecting the mass of the analytedetectable in volume of sample. However, an amount also contemplates arelative amount in comparison to another analyte amount. For example, anamount of an analyte in a sample can be an amount which is greater thana control or normal level of the analyte normally present in the sample.

The term “about” as used herein in reference to quantitativemeasurements not including the measurement of the mass of an ion, refersto the indicated value plus or minus 10%. Mass spectrometry instrumentscan vary slightly in determining the mass of a given analyte. The term“about” in the context of the mass of an ion or the mass/charge ratio ofan ion refers to +/−0.50 atomic mass unit.

The summary of the invention described above is non-limiting and otherfeatures and advantages of the invention will be apparent from thefollowing detailed description of the invention, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-D show exemplary chromatograms for PTAD-25OHD₃, PTAD-25OHD₃-[6,19, 19]-²H₃ (internal standard), PTAD-25OHD₂, and PTAD-25OHD₂-[6, 19,19]-²H₃ (internal standard), respectively. Details are discussed inExample 3.

FIGS. 2A and 2B show exemplary calibration curves for 25OHD₂ and 25OHD₃in serum samples determined by methods described in Example 3.

FIG. 3A shows a plots of coefficient of variation versus concentrationfor 25OHD₂ and 25OHD₃. FIG. 3B shows the same plot expanded near theLLOQ. Details are described in Example 4.

FIGS. 4A-B show linear regression and Deming regression analyses for thecomparison of mass spectrometric determination of 25OHD₂ with andwithout PTAD derivatization. Details are described in Example 10.

FIGS. 5A-B show linear regression and Deming regression analyses for thecomparison of mass spectrometric determination of 25OHD₃ with andwithout PTAD derivatization. Details are described in Example 10.

FIGS. 6A-D show plots comparing the results of analysis of multiplexsamples and unmixed samples (with the same derivatization agent).Details are described in Example 14.

FIGS. 7A-D are plots comparing the results of analysis of the samespecimen treated with different derivatization agents (but comparingmixed versus mixed, or unmixed versus unmixed samples). Details aredescribed in Example 14.

FIGS. 8A-D are plots comparing the results of analysis of the samespecimen treated with different derivatization agents, with one analysiscoming from a mixed sample and one coming from an unmixed sample.Details are described in Example 14.

FIG. 9A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 350 to 450) for 25-hydroxyvitamin D₂ ions. FIG. 9B shows anexemplary product ion spectra (covering the m/z range of about 100 to396) for fragmentation of the 25-hydroxyvitamin D₂ precursor ion withm/z of about 395.2. Details are described in Example 15.

FIG. 10A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 350 to 450) for 25-hydroxyvitamin D₃ ions. FIG. 10B shows anexemplary product ion spectra (covering the m/z range of about 100 to396) for fragmentation of the 25-hydroxyvitamin D₃ precursor ion withm/z of about 383.2. Details are described in Example 15.

FIG. 11A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 520 to 620) for PTAD-25-hydroxyvitamin D₂ ions. FIG. 11B shows anexemplary product ion spectra (covering the m/z range of about 200 to400) for fragmentation of the PTAD-25-hydroxyvitamin D₂ precursor ionwith m/z of about 570.3. Details are described in Example 15.

FIG. 12A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 520 to 620) for PTAD-25-hydroxyvitamin D₃ ions. FIG. 12B shows anexemplary product ion spectra (covering the m/z range of about 200 to400) for fragmentation of the PTAD-25-hydroxyvitamin D₃ precursor ionwith m/z of about 558.3. Details are described in Example 15.

FIG. 13A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 520 to 620) for PTAD-1α,25-dihydroxyvitamin D₂ ions. FIG. 13Bshows an exemplary product ion spectra (covering the m/z range of about250 to 350) for fragmentation of the PTAD-1α,25-dihydroxyvitamin D₂precursor ion with m/z of about 550.4. FIG. 13C shows an exemplaryproduct ion spectra (covering the m/z range of about 250 to 350) forfragmentation of the PTAD-1α,25-dihydroxyvitamin D₂ precursor ion withm/z of about 568.4. FIG. 13D shows an exemplary product ion spectra(covering the m/z range of about 250 to 350) for fragmentation of thePTAD-1α,25-dihydroxyvitamin D₂ precursor ion with m/z of about 586.4.Details are described in Example 16.

FIG. 14A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 520 to 620) for PTAD-1α,25-hydroxyvitamin D₃ ions. FIG. 14B showsan exemplary product ion spectra (covering the m/z range of about 250 to350) for fragmentation of the PTAD-1α,25-dihydroxyvitamin D₃-PTADprecursor ion with m/z of about 538.4. FIG. 14C shows an exemplaryproduct ion spectra (covering the m/z range of about 250 to 350) forfragmentation of the PTAD-1α,25-dihydroxyvitamin D₃ precursor ion withm/z of about 556.4. FIG. 14D shows an exemplary product ion spectra(covering the m/z range of about 250 to 350) for fragmentation of thePTAD-1α,25-dihydroxyvitamin D₃ precursor ion with m/z of about 574.4.Details are described in Example 16.

FIG. 15A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 500 to 620) for PTAD-vitamin D₂ ions. FIG. 15B shows an exemplaryproduct ion spectra (covering the m/z range of about 250 to 350) forfragmentation of the PTAD-vitamin D₂ precursor ion with m/z of about572.2. Details are described in Example 17.

FIG. 16A shows an exemplary Q1 scan spectrum (covering the m/z range ofabout 500 to 620) for PTAD-vitamin D₃ ions. FIG. 16B shows an exemplaryproduct ion spectra (covering the m/z range of about 250 to 350) forfragmentation of the PTAD-vitamin D₃ precursor ion with m/z of about560.2. Details are described in Example 17.

DETAILED DESCRIPTION OF THE INVENTION

Methods are described for measuring steroidal compounds, such as vitaminD and vitamin D related compounds, in a sample. More specifically,methods are described for detecting and quantifying steroidal compoundsin a plurality of test samples in a single mass spectrometric assay. Themethods may utilize Cookson-type reagents, such as PTAD, to generatederivatized steroidal compounds combined with methods of massspectrometry (MS), thereby providing a high-throughput assay system fordetecting and quantifying steroidal compounds in a plurality of testsamples. The preferred embodiments are particularly well suited forapplication in large clinical laboratories for automated steroidalcompound quantification.

Suitable test samples for use in methods of the present inventioninclude any test sample that may contain the analyte of interest. Insome preferred embodiments, a sample is a biological sample; that is, asample obtained from any biological source, such as an animal, a cellculture, an organ culture, etc. In certain preferred embodiments,samples are obtained from a mammalian animal, such as a dog, cat, horse,etc. Particularly preferred mammalian animals are primates, mostpreferably male or female humans. Preferred samples comprise bodilyfluids such as blood, plasma, serum, saliva, cerebrospinal fluid, ortissue samples; preferably plasma (including EDTA and heparin plasma)and serum; most preferably serum. Such samples may be obtained, forexample, from a patient; that is, a living person, male or female,presenting oneself in a clinical setting for diagnosis, prognosis, ortreatment of a disease or condition.

The present invention also contemplates kits for quantitation of one ormore steroidal compounds. A kit for a steroidal compound quantitationassay may include a kit comprising the compositions provided herein. Forexample, a kit may include packaging material and measured amounts of anisotopically labeled internal standard, in amounts sufficient for atleast one assay. Typically, the kits will also include instructionsrecorded in a tangible form (e.g., contained on paper or an electronicmedium) for using the packaged reagents for use in a steroidal compoundquantitation assay.

Calibration and QC pools for use in embodiments of the present inventionare preferably prepared using a matrix similar to the intended samplematrix.

Sample Preparation for Mass Spectrometric Analysis

In preparation for mass spectrometric analysis, one or more steroidalcompounds may be enriched relative to one or more other components inthe sample (e.g. protein) by various methods known in the art, includingfor example, liquid chromatography, filtration, centrifugation, thinlayer chromatography (TLC), electrophoresis including capillaryelectrophoresis, affinity separations including immunoaffinityseparations, extraction methods including ethyl acetate or methanolextraction, and the use of chaotropic agents or any combination of theabove or the like. These enrichment steps may be applied to individualtest samples prior to processing, individual processed samples afterderivatization, or to a multiplex sample after processed samples havebeen combined.

Protein precipitation is one method of preparing a sample, especially abiological sample, such as serum or plasma. Protein purification methodsare well known in the art, for example, Polson et al., Journal ofChromatography B 2003, 785:263-275, describes protein precipitationtechniques suitable for use in methods of the present invention. Proteinprecipitation may be used to remove most of the protein from the sampleleaving one or more steroidal compounds in the supernatant. The samplesmay be centrifuged to separate the liquid supernatant from theprecipitated proteins; alternatively the samples may be filtered toremove precipitated proteins. The resultant supernatant or filtrate maythen be applied directly to mass spectrometry analysis; or alternativelyto liquid chromatography and subsequent mass spectrometry analysis. Incertain embodiments, individual test samples, such as plasma or serum,may be purified by a hybrid protein precipitation/liquid-liquidextraction method. In these embodiments, an unprocessed test sample ismixed with methanol, ethyl acetate, and water, and the resulting mixtureis vortexed and centrifuged. The resulting supernatant, containing oneor more purified steroidal compounds, is removed, dried to completionand reconstituted in acetonitrile. The one or more purified steroidalcompounds in the acetonitrile solution may then be derivatized with anyCookson-type reagent, preferably PTAD or an isotopically labeled variantthereof.

Another method of sample purification that may be used prior to massspectrometry is liquid chromatography (LC). Certain methods of liquidchromatography, including HPLC, rely on relatively slow, laminar flowtechnology. Traditional HPLC analysis relies on column packing in whichlaminar flow of the sample through the column is the basis forseparation of the analyte of interest from the sample. The skilledartisan will understand that separation in such columns is a diffusionalprocess and may select LC, including HPLC, instruments and columns thatare suitable for use with derivatized steroidal compounds. Thechromatographic column typically includes a medium (i.e., a packingmaterial) to facilitate separation of chemical moieties (i.e.,fractionation). The medium may include minute particles, or may includea monolithic material with porous channels. A surface of the mediumtypically includes a bonded surface that interacts with the variouschemical moieties to facilitate separation of the chemical moieties. Onesuitable bonded surface is a hydrophobic bonded surface such as an alkylbonded, cyano bonded surface, or highly pure silica surface. Alkylbonded surfaces may include C-4, C-8, C-12, or C-18 bonded alkyl groups.In preferred embodiments, the column is a highly pure silica column(such as a Thermo Hypersil Gold Aq column). The chromatographic columnincludes an inlet port for receiving a sample and an outlet port fordischarging an effluent that includes the fractionated sample. Thesample may be supplied to the inlet port directly, or from an extractioncolumn, such as an on-line SPE cartridge or a TFLC extraction column. Inpreferred embodiments, a multiplex sample may be purified by liquidchromatography prior to mass spectrometry.

In one embodiment, the multiplex sample may be applied to the LC columnat the inlet port, eluted with a solvent or solvent mixture, anddischarged at the outlet port. Different solvent modes may be selectedfor eluting the analyte(s) of interest. For example, liquidchromatography may be performed using a gradient mode, an isocraticmode, or a polytyptic (i.e. mixed) mode. During chromatography, theseparation of materials is effected by variables such as choice ofeluent (also known as a “mobile phase”), elution mode, gradientconditions, temperature, etc.

In certain embodiments, analytes may be purified by applying a multiplexsample to a column under conditions where analytes of interest arereversibly retained by the column packing material, while one or moreother materials are not retained. In these embodiments, a first mobilephase condition can be employed where the analytes of interest areretained by the column, and a second mobile phase condition cansubsequently be employed to remove retained material from the columnonce the non-retained materials are washed through. Alternatively,analytes may be purified by applying a multiplex sample to a columnunder mobile phase conditions where the analytes of interest elute at adifferential rates in comparison to one or more other materials. Suchprocedures may enrich the amount of an analyte of interest in the eluentat a particular time (i.e., a characteristic retention time) relative toone or more other components of the sample.

In one preferred embodiment, HPLC is conducted with an alkyl bondedanalytical column chromatographic system. In certain preferredembodiments, a highly pure silica column (such as a Thermo Hypersil GoldAq column) is used. In certain preferred embodiments, HPLC and/or TFLCare performed using HPLC Grade water as mobile phase A and HPLC Gradeethanol as mobile phase B.

By careful selection of valves and connector plumbing, two or morechromatography columns may be connected as needed such that material ispassed from one to the next without the need for any manual steps. Inpreferred embodiments, the selection of valves and plumbing iscontrolled by a computer pre-programmed to perform the necessary steps.Most preferably, the chromatography system is also connected in such anon-line fashion to the detector system, e.g., an MS system. Thus, anoperator may place a tray of samples in an autosampler, and theremaining operations are performed under computer control, resulting inpurification and analysis of all samples selected.

In some embodiments, an extraction column may be used for purificationof steroidal compounds prior to mass spectrometry. In such embodiments,samples may be extracted using a extraction column which captures theanalyte, then eluted and chromatographed on a second extraction columnor on an analytical HPLC column prior to ionization. For example, sampleextraction with a TFLC extraction column may be accomplished with alarge particle size (50 μm) packed column. Sample eluted off of thiscolumn may then be transferred to an HPLC analytical column for furtherpurification prior to mass spectrometry. Because the steps involved inthese chromatography procedures may be linked in an automated fashion,the requirement for operator involvement during the purification of theanalyte can be minimized. This feature may result in savings of time andcosts, and eliminate the opportunity for operator error.

In some embodiments, protein precipitation is accomplished with a hybridprotein precipitation/liquid-liquid extraction method which includesmethanol protein precipitation and ethyl acetate/water extraction fromserum test samples. The resulting steroidal compounds may be derivatizedprior to being subjected to an extraction column. Preferably, the hybridprotein precipitation/liquid-liquid extraction method and the extractioncolumn are connected in an on-line fashion. In preferred embodimentswhere the steroidal compounds are selected from the group consisting ofvitamin D and vitamin D related compounds, the extraction column ispreferably a C-8 extraction column, such as a Cohesive Technologies C8XLonline extraction column (50 μm particle size, 0.5×50 mm) or equivalent.The eluent from the extraction column may then be applied to ananalytical LC column, such as a HPLC column in an on-line fashion, priorto mass spectrometric analysis. Because the steps involved in thesechromatography procedures may be linked in an automated fashion, therequirement for operator involvement during the purification of theanalyte can be minimized. This feature may result in savings of time andcosts, and eliminate the opportunity for operator error.

Detection and Quantitation by Mass Spectrometry

In various embodiments, derivatized steroidal compounds may be ionizedby any method known to the skilled artisan. Mass spectrometry isperformed using a mass spectrometer, which includes an ion source forionizing the fractionated sample and creating charged molecules forfurther analysis. For example ionization of the sample may be performedby electron ionization, chemical ionization, electrospray ionization(ESI), photon ionization, atmospheric pressure chemical ionization(APCI), photoionization, atmospheric pressure photoionization (APPI),fast atom bombardment (FAB), liquid secondary ionization (LSI), matrixassisted laser desorption ionization (MALDI), field ionization, fielddesorption, thermospray/plasmaspray ionization, surface enhanced laserdesorption ionization (SELDI), inductively coupled plasma (ICP),particle beam ionization, and LDTD. The skilled artisan will understandthat the choice of ionization method may be determined based on theanalyte to be measured, type of sample, the type of detector, the choiceof positive versus negative mode, etc.

Derivatized steroidal compounds may be ionized in positive or negativemode. In preferred embodiments, derivatized steroidal compounds areionized by APCI in positive mode. In related preferred embodiments,derivatized steroidal compounds ions are in a gaseous state and theinert collision gas is argon or nitrogen; preferably argon.

In mass spectrometry techniques generally, after the sample has beenionized, the positively or negatively charged ions thereby created maybe analyzed to determine a mass-to-charge ratio. Suitable analyzers fordetermining mass-to-charge ratios include quadrupole analyzers, iontraps analyzers, and time-of-flight analyzers. Exemplary ion trapmethods are described in Bartolucci, et al., Rapid Commun. MassSpectrom. 2000, 14:967-73.

The ions may be detected using several detection modes. For example,selected ions may be detected, i.e. using a selective ion monitoringmode (SIM), or alternatively, mass transitions resulting from collisioninduced dissociation or neutral loss may be monitored, e.g., multiplereaction monitoring (MRM) or selected reaction monitoring (SRM).Preferably, the mass-to-charge ratio is determined using a quadrupoleanalyzer. For example, in a “quadrupole” or “quadrupole ion trap”instrument, ions in an oscillating radio frequency field experience aforce proportional to the DC potential applied between electrodes, theamplitude of the RF signal, and the mass/charge ratio. The voltage andamplitude may be selected so that only ions having a particularmass/charge ratio travel the length of the quadrupole, while all otherions are deflected. Thus, quadrupole instruments may act as both a “massfilter” and as a “mass detector” for the ions injected into theinstrument.

One may enhance the resolution of the MS technique by employing “tandemmass spectrometry,” or “MS/MS”. In this technique, a precursor ion (alsocalled a parent ion) generated from a molecule of interest can befiltered in an MS instrument, and the precursor ion subsequentlyfragmented to yield one or more fragment ions (also called daughter ionsor product ions) that are then analyzed in a second MS procedure. Bycareful selection of precursor ions, only ions produced by certainanalytes are passed to the fragmentation chamber, where collisions withatoms of an inert gas produce the fragment ions. Because both theprecursor and fragment ions are produced in a reproducible fashion undera given set of ionization/fragmentation conditions, the MS/MS techniquemay provide an extremely powerful analytical tool. For example, thecombination of filtration/fragmentation may be used to eliminateinterfering substances, and may be particularly useful in complexsamples, such as biological samples.

Alternate modes of operating a tandem mass spectrometric instrumentinclude product ion scanning and precursor ion scanning. For adescription of these modes of operation, see, e.g., E. Michael Thurman,et al., Chromatographic-Mass Spectrometric Food Analysis for TraceDetermination of Pesticide Residues, Chapter 8 (Amadeo R.Fernandez-Alba, ed., Elsevier 2005) (387).

The results of an analyte assay may be related to the amount of theanalyte in the original sample by numerous methods known in the art. Forexample, given that sampling and analysis parameters are carefullycontrolled, the relative abundance of a given ion may be compared to atable that converts that relative abundance to an absolute amount of theoriginal molecule. Alternatively, external standards may be run with thesamples, and a standard curve constructed based on ions generated fromthose standards. Using such a standard curve, the relative abundance ofa given ion may be converted into an absolute amount of the originalmolecule. In certain preferred embodiments, an internal standard is usedto generate a standard curve for calculating the quantity of steroidalcompounds. Methods of generating and using such standard curves are wellknown in the art and one of ordinary skill is capable of selecting anappropriate internal standard. For example, in some embodiments, one ormore isotopically labeled vitamin D metabolites (e.g., 25OHD₂-[6, 19,19]-²H₃ and 25OHD₃-[6, 19, 19]-²H₃) may be used as internal standards.Numerous other methods for relating the amount of an ion to the amountof the original molecule will be well known to those of ordinary skillin the art.

One or more steps of the methods may be performed using automatedmachines. In certain embodiments, one or more purification steps areperformed on-line, and more preferably all of the purification and massspectrometry steps may be performed in an on-line fashion.

In certain mass spectrometry techniques, such as MS/MS, precursor ionsare isolated for further fragmentation though collision activateddissociation (CAD). In CAD, precursor ions gain energy throughcollisions with an inert gas, and subsequently fragment by a processreferred to as “unimolecular decomposition.” Sufficient energy must bedeposited in the precursor ion so that certain bonds within the ion canbe broken due to increased vibrational energy.

Steroidal compounds in a sample may be detected and/or quantified usingMS/MS as follows. The samples may first be purified by proteinprecipitation or a hybrid protein precipitation/liquid-liquidextraction. Then, one or more steroidal compounds in the purified sampleare derivatized with a Cookson-type reagent, such as PTAD or an isotopicvariant thereof. The purified samples may then subjected to liquidchromatography, preferably on an extraction column (such as a TFLCcolumn) followed by an analytical column (such as a HPLC column); theflow of liquid solvent from a chromatographic column enters thenebulizer interface of an MS/MS analyzer; and the solvent/analytemixture is converted to vapor in the heated charged tubing of theinterface. The analyte(s) (e.g., derivatized steroidal compounds such asderivatized vitamin D metabolites), contained in the solvent, areionized by applying a large voltage to the solvent/analyte mixture. Asthe analytes exit the charged tubing of the interface, thesolvent/analyte mixture nebulizes and the solvent evaporates, leavinganalyte ions. Alternatively, derivatized steroidal compounds in thepurified samples may not be subject to liquid chromatography prior toionization. Rather, the samples may be spotted in a 96-well plate andvolatilized and ionized via LDTD.

The ions, e.g. precursor ions, pass through the orifice of a tandem massspectrometric (MS/MS) instrument and enter the first quadrupole. In atandem mass spectrometric instrument, quadrupoles 1 and 3 (Q1 and Q3)are mass filters, allowing selection of ions (i.e., selection of“precursor” and “fragment” ions in Q1 and Q3, respectively) based ontheir mass to charge ratio (m/z). Quadrupole 2 (Q2) is the collisioncell, where ions are fragmented. The first quadrupole of the massspectrometer (Q1) selects for molecules with the mass to charge (m/z)ratios of derivatized steroidal compounds of interest. Precursor ionswith the correct mass/charge ratios are allowed to pass into thecollision chamber (Q2), while unwanted ions with any other mass/chargeratio collide with the sides of the quadrupole and are eliminated.Precursor ions entering Q2 collide with neutral argon gas molecules andfragment. The fragment ions generated are passed into quadrupole 3 (Q3),where the fragment ions of derivatized steroidal compounds of interestare selected while other ions are eliminated.

The methods may involve MS/MS performed in either positive or negativeion mode; preferably positive ion mode. Using standard methods wellknown in the art, one of ordinary skill is capable of identifying one ormore fragment ions of a particular precursor ion of derivatizedsteroidal compounds that may be used for selection in quadrupole 3 (Q3).

As ions collide with the detector they produce a pulse of electrons thatare converted to a digital signal. The acquired data is relayed to acomputer, which plots counts of the ions collected versus time. Theresulting mass chromatograms are similar to chromatograms generated intraditional HPLC-MS methods. The areas under the peaks corresponding toparticular ions, or the amplitude of such peaks, may be measured andcorrelated to the amount of the analyte of interest. In certainembodiments, the area under the curves, or amplitude of the peaks, forfragment ion(s) and/or precursor ions are measured to determine theamount of a particular steroidal compounds. As described above, therelative abundance of a given ion may be converted into an absoluteamount of the original analyte using calibration standard curves basedon peaks of one or more ions of an internal molecular standard.

Processing Patient Samples for Analysis of Multiplex Patient Samples

Following the procedures outlined above, multiple patient samples can bemultiplex (i.e., mixed and assayed together) if each patient sample isprocessed differently. The phrase “processed differently” means thateach patient sample to be included in the multiplex sample is processedin such a way that steroidal compounds in two or more patient samplesthat are originally indistinguishable by mass spectrometry becomedistinguishable after processing. This may be accomplished by processingeach patient sample with a different agent that derivitizes steroidalcompounds. The derivatizing agents selected for use must generatederivatized steroidal compounds that are distinguishable by massspectrometry. The basis for distinguishing derivatized steroidalcompounds by mass spectrometry will be a difference in the mass of ionsfrom the derivatized steroidal compounds. The differences in mass mayarise from the use of two or more different derivatizing agents, such asPTAD and DMEQTAD. Differences in mass may also arise from the use of twoor more isotopic variants of the same derivatizing agent, such as PTADand ¹³C₆-PTAD. These two approaches are not mutually exclusive, and anycombination of different derivatizing agents and isotopic variants ofthe same agent may be used to uniquely label steroidal compounds in eachpatient sample in the plurality of patient samples to be analyzed.Optionally, one sample from the plurality of patient samples may beprocessed without a derivatizing agent.

After processing a plurality of patient samples, a particular steroidalcompound from one patient sample will have a different massspectrometric profile than the same steroidal compound in other patientsamples. When processed patient samples are mixed to form a multiplexsample which is then analyzed to determine the levels of processedsteroidal compounds, the differences in mass spectrometric profiles ofthe detected processed steroidal compounds allow for each processedsteroidal compound to be attributed to an originating patient sample.Thus, the amounts of a steroidal compound in two or more patient samplesare determined by a single mass spectrometric analysis of a multiplexsample.

As indicated above, different Cookson-type reagents may be used asderivatizing agents for different patient samples; for example, onepatient sample may be derivatized with PTAD, and a second patient samplederivatized with DMEQTAD. Using different Cookson-type reagentsgenerally results in large mass differences between the derivatizedanalytes. For example, the difference in mass between a steroidalcompound derivatized with PTAD and the same compound derivatized withDMEQTAD is about 200 mass units (the mass difference between PTAD andDMEQTAD).

Isotopic variants of the same Cookson-type reagent may also be used tocreate distinguishable derivatives in multiple patient samples. Forexample, one patient sample may be derivatized with PTAD, and a secondpatient sample may be derivatized with ¹³C₆-PTAD. In this example, thedifference in mass between PTAD and ¹³C₆-PTAD is about 6 mass units.

The following Examples serve to illustrate the invention throughprocessing multiple patient samples with isotopic variants of PTAD.These Examples are in no way intended to limit the scope of the methods.In particular, the following Examples demonstrate quantitation ofvitamin D metabolites by mass spectrometry with the use of 25OHD₂-[6,19, 19]-²H₃ or 25OHD₃-[6, 19, 19]-²H₃ as internal standards.Demonstration of the methods of the present invention as applied tovitamin D metabolites does not limit the applicability of the methods toonly vitamin D and vitamin D related compounds. Similarly, the use of25OHD₂-[6, 19, 19]-²H₃ or 25OHD₃-[6, 19, 19]-²H₃ as internal standardsare not meant to be limiting in any way. Any appropriate chemicalspecies, easily determined by one in the art, may be used as an internalstandard for steroidal compound quantitation.

EXAMPLES Example 1 Hybrid Protein Precipitation/Liquid-Liquid Extractionand Cookson-Type Derivatization

The following automated hybrid protein precipitation/liquid-liquidextraction technique was conducted on patient serum samples. Gel BarrierSerum (i.e., serum collected in Serum Separator Tubes) as well as EDTAplasma and Heparin Plasma have also been established as acceptable forthis assay.

A Perkin-Elmer Janus robot and a TomTec Quadra Tower robot was used toautomate the following procedure. For each sample, 50 μL of serum wasadded to a well of a 96 well plate. Then 25 μL of internal standardcocktail (containing isotopically labeled 25OHD₂-[6, 19, 19]-²H₃ and25OHD₃-[6, 19, 19]-²H₃) was added to each well, and the plate vortexed.Then 75 μL of methanol was added, followed by additional vortexing. 300μL of ethyl acetate and 75 μL of water was then added, followed byadditional vortexing, centrifugation, and transfer of the resultingsupernatant to a new 96-well plate.

The transferred liquid in the second 96-well plate from Example 1 wasdried to completion under a flowing nitrogen gas manifold.Derivatization was accomplished by adding 100 μL of a 0.1 mg/mL solutionof the Cookson-type derivatization agent PTAD in acetonitrile to eachwell. The derivatization reaction was allowed to proceed forapproximately one hour, and was quenched by adding 100 μL of water tothe reaction mixture.

Example 2 Extraction of Vitamin D Metabolites with Liquid Chromatography

Sample injection was performed with a Cohesive Technologies Aria TX-4TFLC system using Aria OS V 1.5.1 or newer software.

The TFLC system automatically injected an aliquot of the above preparedsamples into a Cohesive Technologies C8XL online extraction column (50μm particle size, 005×50 mm, from Cohesive Technologies, Inc.) packedwith large particles. The samples were loaded at a high flow rate tocreate turbulence inside the extraction column. This turbulence ensuredoptimized binding of derivatized vitamin D metabolites to the largeparticles in the column and the passage of excess derivatizing reagentand debris to waste.

Following loading, the sample was eluted off to the analytical column, aThermo Hypersil Gold Aq analytical column (5 μm particle size, 50×2.1mm), with a water/ethanol elution gradient. The HPLC gradient wasapplied to the analytical column, to separate vitamin D metabolites fromother analytes contained in the sample. Mobile phase A was water andmobile phase B was ethanol. The HPLC gradient started with a 35% organicgradient which was ramped to 99% in approximately 65 seconds.

Example 3 Detection and Quantitation of Derivatized Vitamin DMetabolites by MS/MS

MS/MS was performed using a Finnigan TSQ Quantum Ultra MS/MS system(Thermo Electron Corporation). The following software programs, all fromThermo Electron, were used in the Examples described herein: QuantumTune Master V 1.5 or newer, Xcalibur V 2.07 or newer, LCQuan V 2.56(Thermo Finnigan) or newer, and ARIA OS v1.5.1 (Cohesive Technologies)or newer. Liquid solvent/analyte exiting the analytical column flowed tothe nebulizer interface of the MS/MS analyzer. The solvent/analytemixture was converted to vapor in the tubing of the interface. Analytesin the nebulized solvent were ionized by ESI.

Ions passed to the first quadrupole (Q1), which selected ions for aderivatized vitamin D metabolite. Ions with a m/z of 570.32±0.50 wereselected for PTAD-25OHD₂; ions with a m/z of 558.32±0.50 were selectedfor PTAD-25OHD₃. Ions entering quadrupole 2 (Q2) collided with argon gasto generate ion fragments, which were passed to quadrupole 3 (Q3) forfurther selection. Mass spectrometer settings are shown in Table 1.Simultaneously, the same process using isotope dilution massspectrometry was carried out with internal standards, PTAD-25OHD₂-[6,19, 19]-²H₃ and PTAD-25OHD₃-[6, 19, 19]-²H₃. The following masstransitions were used for detection and quantitation during validationon positive polarity. The indicated mass transitions are not meant to belimiting in any way. As seen in the Examples that follow, other masstransitions could be selected for each analyte to generate quantitativedata.

TABLE 1 Mass Spectrometer Settings for Detection of PTAD-25OHD₂ andPTAD-25OHD₃. Mass Spectrometric Instrument Settings Discharge Current4.0 μA Vaporizer Temperature 300 C. Sheath Gas Pressure 15 Ion Sweep GasPressure 0.0 Aux Gas Pressure 5 Capillary Temperature 300 C. SkimmerOffset −10 V Collision Pressure 1.5 mTorr Collision Cell Energy 15 V

TABLE 2 Exemplary Mass Transitions for PTAD-25OHD₂, PTAD-25OHD₂-[6, 19,19]-²H₃ (IS), PTAD-25OHD₃, and PTAD-25OHD₃-[6, 19, 19]-²H₃ (IS)(Positive Polarity) Analyte Precursor Ion (m/z) Product Ion (m/z)PTAD-25OHD₂ 570.32 298.09 PTAD-25OHD₂- 573.32 301.09 [6, 19, 19]-²H₃(IS) PTAD-25OHD₃ 558.32 298.09 PTAD-25OHD₃- 561.32 301.09 [6, 19,19]-²H₃ (IS)

Exemplary chromatograms for PTAD-25OHD₃, PTAD-25OHD₃-[6, 19, 19]-²H₃(1S), PTAD-25OHD₂, and PTAD-25OHD₂-[6, 19, 19]-²H₃ (1S) are found inFIGS. 1A, 1B, 1C, and 1D, respectively.

Exemplary calibration curves for the determination of 25OHD₂ and 25OHD₃in serum specimens are shown in FIGS. 2A and 2B, respectively.

Example 4 Analytical Sensitivity: Lower Limit of Quantitation (LLOQ) andLimit of Detection CLOD)

The LLOQ is the point where measurements become quantitativelymeaningful. The analyte response at this LLOQ is identifiable, discreteand reproducible with a precision (i.e., coefficient of variation (CV))of greater than 20% and an accuracy of 80% to 120%. The LLOQ wasdetermined by assaying five different human serum samples spiked withPTAD-25OHD₂ and PTAD-25OHD₃ at levels near the expected LLOQ andevaluating the reproducibility. Analysis of the collected data indicatesthat samples with concentrations of about 4 ng/mL yielded CVs of about20%. Thus, the LLOQ of this assay for both PTAD-25OHD₂ and PTAD-25OHD₃was determined to be about 4 ng/mL. The graphical representations of CVversus concentration for both analytes are shown in FIGS. 3A-B (FIG. 3Ashows the plots over an expanded concentration range, while FIG. 3Bshows the same plot expanded near the LOQ).

The LOD is the point at which a value is beyond the uncertaintyassociated with its measurement and is defined as three standarddeviations from the zero concentration. To determine the LOD, generally,blank samples of the appropriate matrix are obtained and tested forinterferences. However, no appropriate biological matrix could beobtained where the endogenous concentration of 25OHD₃ is zero, so asolution of 5% bovine serum albumin in phosphate buffered saline (withan estimated 1.5 ng/mL 25OHD₃) was used for LOD studies. The standardwas run in 20 replicates each and the resulting area rations werestatistically analyzed to determine that the LOD for 25OHD₂ and 25OHD₃are about 1.9 and 3.3 ng/mL, respectively. Raw data from these studiesis presented in Table 3, below

TABLE 23 Limit of Detection Raw Data and Analysis Replicate 25OHD₂(ng/mL) 25OHD₃ (ng/mL)  1 0.0 0.0  2 1.1 2.0  3 0.1 2.4  4 0.3 1.1  50.5 1.9  6 0.4 1.8  7 0.2 1.9  8 0.5 2.3  9 1.1 2.3 10 0.5 2.1 11 0.41.5 12 1.2 1.9 13 0.4 1.8 14 0.3 1.6 15 0.0 1.3 16 0.9 1.3 17 0.8 1.5 180.1 1.9 19 0.5 1.7 20 0.4 1.8 Mean 0.4 1.7 SD 0.5 0.5 LOD (Mean + 3SD)1.9 3.3

Example 5 Reportable Range and Linearity

Linearity of derivatized vitamin D metabolite detection in the assay wasdetermined by diluting four pools serum with high endogenousconcentration of either 25OHD₂ or 25OHD₃ and analyzing undilutedspecimens and diluted specimens at 1:2, 1:4, and 1:8, in quadruplicate.Quadratic regression of the data was performed yielding correlationcoefficients across the concentration range tested of R²=0.97. Thesestudies demonstrated that specimens may be diluted at 1:4 with averagerecovery of 101%, permitting a reportable range of about 4 to about 512ng/mL. Average measured values for each of the specimen dilution levelsand correlation values from linear regression analysis are presented inTable 4A, below. Percent recoveries for each of the specimen dilutionlevels are presented in Table 4B, below.

TABLE 4A Linearity Data and Linear Regression Analysis over ReportableRange Dilution 25OHD₂ (ng/mL) 25OHD₃ (ng/mL) Level Pool 1 Pool 2 Pool 1Pool 2 Undiluted 110.0 75.6 73.3 60.6 1:2 55.5 39.3 35.7 28.7 1:4 26.219.4 18.1 16.3 1:8 14.3 10.9 9.7 8.3 R² 0.9744 0.9721 0.9705 0.9601

TABLE 4B Percent Recovery at Various Specimen Dilution Levels 25OHD₂(ng/mL) 25OHD₃ (ng/mL) Dilution Level Pool 1 Pool 2 Pool 1 Pool 2Undiluted (100%) (100%) (100%) (100%) 1:2 100.9 104 97.4 94.8 1:4 95.5102.7 98.6 107.3 1:8 104.2 115.0 106.0 109.0

Example 6 Analyte Specificity

The specificity of the assay against similar analytes was determined tohave no cross reactivity for any vitamin D metabolite tested with theexception of 3-epi-25OHD₃, which behaves similarly to 25OHD₃ in theassay. The side-chain labeled stable isotopes of 25OHD2 and 25OHD₃ alsoshowed cross-reactivity owing to hydrogen exchange that occurs in theion source. Thus, side-chain labeled stable isotopes of 25OHD₂ and25OHD₃ should not be used as internal standards. Table 5, below, showsthe compounds tested and the results of the cross-reactivity studies.

TABLE 5 Cross-Reactivity Studies (Compounds tested and results) Analyte25OHD₂ 25OHD₃ Cross-Reactivity 1,25(OH)₂D₃ — — No 1,25(OH)₂D₂ — — No1,25(OH)₂D₃-[6,19,19′]-²H — — No 1,25(OH)₂D₃-[26,26,26,27,27,27]-²H — —No 1,25(OH)₂D₂-[26,26,26,27,27,27]-²H — — No 25OHD₃ — (100%) — 25OHD₂(100%) — — 25OHD₃—IS-[6,19,19′]-²H — — No 25OHD₂—IS-[6,19,19′]-²H — — No25OHD₃—IS-[26,26,26,27,27,27]-²H — 13.8% Yes25OHD₂—IS-[26,26,26,27,27,27]-²H 2.7% — Yes vitamin D₃ — — No vitamin D₂— — No vitamin D₃-[6,19,19′]-²H — — No vitamin D₂-[6,19,19′]-²H — — Novitamin D₃-[26,26,26,27,27,27]-²H — — No vitaminD₂-[26,26,26,27,27,27]-²H — — No 1-OH—D₃ (Alfacalcidiol) — — No 1-OH—D₂(Hectoral) — — No 24,25(OH)₂D₃ — — No 25,26(OH)₂D₃ — — No 3-epi-25OHD₃ —— No 3-epi-1,25(OH)₂D₃ — 33.3% Yes Dihydrotachysterol — — No1,25(OH)₂D₃-26,23-lactone — — No Paracalcitol (Zemplar) — — NoCalcipotriene (Dovonex) — — No 7-Dehydrocholesterol — — No

Example 7 Reproducibility

Six standards at 5, 15, 30, 60, 90, and 120 ng/mL for each analyte wererun in every assay as a means as quantitating reproducibility. Theday-to-day reproducibility was determined using calibration curves from19 assays. The data from these 19 assays are presented in Tables 6A (for25OHD₂) and 6B (for 25OHD₃).

TABLE 6A Standard curves demonstrate reproducibility of 25OHD₂-PTADdetermination. Concentration 5 15 30 60 90 120 Assay ng/mL ng/mL ng/mLng/mL ng/mL ng/mL 1 0.06 0.16 0.36 0.68 0.92 1.23 2 0.08 0.17 0.36 0.610.94 1.18 3 0.07 0.17 0.32 0.66 0.92 1.19 4 0.06 0.19 0.29 0.69 0.981.16 5 0.07 0.15 0.37 0.60 0.85 1.13 6 0.07 0.16 0.32 0.64 0.95 1.20 70.07 0.16 0.35 0.63 0.99 1.18 8 0.06 0.16 0.35 0.60 0.98 1.31 9 0.060.18 0.32 0.66 0.96 1.10 10 0.06 0.15 0.35 0.62 0.89 1.22 11 0.05 0.170.33 0.65 0.96 1.17 12 0.04 0.17 0.32 0.61 0.97 1.12 13 0.05 0.16 0.340.62 0.97 1.30 14 0.06 0.17 0.31 0.61 0.95 1.21 15 0.07 0.16 0.34 0.700.94 1.30 16 0.08 0.17 0.39 0.70 1.06 1.27 17 0.06 0.15 0.36 0.65 1.031.20 18 0.05 0.18 0.34 0.81 0.91 1.33 19 0.06 0.17 0.30 0.62 1.06 1.21Avg 0.06 0.16 0.34 0.65 0.96 1.21 SD 0.01 0.01 0.02 0.05 0.05 0.07 CV %15.4 6.3 7.4 8.0 5.6 5.4

TABLE 6B Standard curves demonstrate reproducibility of 25OHD₃-PTADdetermination. Concentration 5 15 30 60 90 120 Assay ng/mL ng/mL ng/mLng/mL ng/mL ng/mL 1 0.07 0.16 0.36 0.61 0.95 1.19 2 0.07 0.17 0.32 0.661.01 1.12 3 0.06 0.16 0.32 0.60 1.00 1.16 4 0.06 0.17 0.31 0.60 0.941.09 5 0.05 0.16 0.33 0.65 0.96 1.11 6 0.07 0.17 0.34 0.65 0.87 1.13 70.07 0.17 0.31 0.61 0.95 1.21 8 0.06 0.15 0.29 0.58 0.90 1.21 9 0.070.17 0.32 0.65 0.88 1.15 10 0.06 0.14 0.30 0.57 1.05 1.16 11 0.06 0.150.30 0.56 0.87 1.15 12 0.05 0.15 0.31 0.64 0.85 1.06 13 0.06 0.16 0.330.60 0.88 1.08 14 0.06 0.17 0.31 0.61 0.91 1.22 15 0.06 0.18 0.34 0.660.96 1.18 16 0.06 0.17 0.35 0.65 0.94 1.21 17 0.06 0.17 0.36 0.64 0.941.17 18 0.07 0.17 0.34 0.66 0.98 1.18 19 0.07 0.16 0.34 0.68 0.84 1.27Avg 0.06 0.16 0.33 0.63 0.93 1.16 SD 0.00 0.01 0.02 0.03 0.06 0.05 CV %7.9 5.8 5.9 5.5 6.1 4.6

Example 8 Intra-Assay and Inter-Assay Variation Studies

Intra-assay variation is defined as the reproducibility of results for asample within a single assay. To assess intra-assay variation, twentyreplicates from each of four quality control (QC) pools covering thereportable range of the assay were prepared and measured from pooledserum with 25OHD₂ and 25OHD₃ at arbitrary ultralow, low, medium, andhigh concentrations for each analyte. Acceptable levels for thecoefficient of variation (CV) are less then 15% for the three higherconcentration, and less than 20% for the lowest concentration (at ornear the LOQ for the assay).

The results of the intra-assay variation studies indicate that the CVfor the four QC pools are 9.1%, 6.4%, 5.0%, and 5.9% with meanconcentrations of 13.7 ng/mL, 30.0 ng/mL, 52.4 ng/mL, and 106.9 ng/mL,respectively, for PTAD-25OHD₂, and 3.5%, 4.9%, 5.1%, and 3.3% with meanconcentrations of 32.8 ng/mL, 15.0 ng/mL, 75.4 ng/mL, and 102.3 ng/mL,respectively, for PTAD-25OHD₃. The data from analysis of thesereplicates is shown in Tables 7A and 7B.

TABLE 7A PTAD-25OHD₂ Intra-assay variation studies. QC (U) QC (L) QC (M)QC (H) Lot # 090837 Lot # 090838 Lot # 090839 Lot # 090840 Replicateng/mL ng/mL ng/mL ng/mL 1 15.2 31.4 49.5 108.9 2 12.3 29.7 53.2 109.3 313.8 30.8 50.9 98.9 4 12.4 30.1 50.4 111.5 5 14.6 27.2 49.7 109.0 6 14.629.1 47.6 110.3 7 13.6 33.0 53.3 95.6 8 11.4 29.9 53.3 98.5 9 14.0 31.555.2 110.7 10 13.7 29.1 49.0 113.5 11 13.7 29.5 56.8 100.4 12 13.0 25.554.1 105.4 13 15.6 34.2 53.6 102.0 14 11.7 28.7 52.9 103.2 15 13.5 28.149.4 121.0 16 13.6 29.8 52.0 102.9 17 13.1 29.4 56.8 113.4 18 14.4 30.654.5 103.3 19 16.2 31.6 53.1 110.8 20 12.7 30.7 — 110.4 Avg 0.06 0.160.33 0.63 SD 0.00 0.01 0.02 0.03 CV % 7.9 5.8 5.9 5.5

TABLE 7B PTAD-25OHD₃ Intra-assay variation studies. QC (U) QC (L) QC (M)QC (H) Lot # 090837 Lot # 090838 Lot # 090839 Lot # 090840 Replicateng/mL ng/mL ng/mL ng/mL 1 34.4 13.7 75.7 101.7 2 35.0 14.2 78.7 101.8 333.2 14.7 73.1 103.2 4 34.4 14.9 83.7 104.1 5 32.4 14.5 72.7 107.0 633.3 14.3 73.6 107.6 7 33.8 15.0 79.1 97.5 8 32.1 15.8 73.1 98.7 9 32.415.5 74.2 106.5 10 31.4 15.4 74.5 106.1 11 31.8 14.7 69.3 105.9 12 31.216.8 73.5 97.7 13 34.1 15.4 72.7 104.9 14 33.8 15.3 75.1 99.8 15 32.015.7 76.2 102.2 16 33.2 14.7 74.2 102.2 17 32.6 14.7 85.0 100.5 18 31.613.9 75.5 101.8 19 31.3 15.6 73.6 99.9 20 32.5 15.3 — 96.3 Avg 32.8 15.075.4 102.3 SD 1.1 0.7 3.8 3.4 CV % 3.5 4.9 5.1 3.3

Five aliquots of each of the same four QC pools were assayed over sixdays to determine the coefficient of variation (CV) between assays. Theresults of the intra-assay variation studies indicate that theinter-assay CV for the four QC pools are about 8.3%, 6.2%, 8.1%, and6.4% with mean concentrations of about 13.1 ng/mL, 29.8 ng/mL, 51.9ng/mL, and 107.8 ng/mL, respectively, for PTAD-25OHD₂, and about 4.8%,6.7%, 4.7%, and 6.7% with mean concentrations of about 31.1 ng/mL, 14.5ng/mL, 75.1 ng/mL, and 108.4 ng/mL, respectively, for PTAD-25OHD₃. Thedata from analysis of these replicates is shown in Tables 8A and 8B.

TABLE 8A PTAD-25OHD₂ Inter-assay variation studies. QC (U) QC (L) QC (M)QC (H) Lot # 090837 Lot # 090838 Lot # 090839 Lot # 090840 Assay ng/mLng/mL ng/mL ng/mL 1 13.6 28.1 51.7 119.6 12.8 30.1 49.4 117.9 14.6 32.049.7 105.1 13.0 30.8 52.3 100.2 13.0 29.2 56.6 110.3 2 12.9 31.3 46.3108.1 13.5 30.3 52.1 117.8 10.9 29.7 46.9 105.8 11.2 30.6 43.6 105.212.8 28.7 50.3 104.9 3 12.6 28.8 56.5 115.3 16.4 29.3 63.8 103.0 13.226.2 45.5 103.2 11.5 30.8 53.8 113.2 12.4 33.7 51.6 106.9 4 12.1 28.558.5 97.0 13.9 26.2 51.8 115.1 14.4 29.6 48.9 112.2 13.1 32.1 52.3 97.912.6 30.5 52.2 104.2 5 12.7 29.9 54.5 101.3 14.3 28.3 46.3 102.2 13.930.0 56.1 111.4 13.1 32.6 51.2 123.1 12.4 26.2 51.2 98.3 6 12.5 30.650.1 104.6 12.9 32.6 51.8 104.8 14.0 28.6 53.7 108.9 14.3 29.1 51.0113.8 12.9 29.1 56.4 102.2 Avg 13.1 29.8 51.9 107.8 SD 1.1 1.8 4.2 6.8CV % 8.3 6.2 8.1 6.4

TABLE 8B PTAD-25OHD₃ Inter-assay variation studies. QC (U) QC (L) QC (M)QC (H) Lot # 090837 Lot # 090838 Lot # 090839 Lot # 090840 Assay ng/mLng/mL ng/mL ng/mL 1 32.6 13.4 76.7 104.9 30.0 12.7 77.6 107.0 34.1 15.478.4 107.1 34.0 14.8 76.6 105.1 30.2 15.5 74.8 110.2 2 33.5 13.2 69.8109.8 32.4 14.3 75.0 106.4 30.2 16.2 73.4 112.1 31.4 16.1 71.9 97.0 31.413.7 75.2 117.5 3 31.5 13.3 70.2 112.4 32.1 14.6 82.6 101.5 31.0 15.470.8 99.8 28.7 15.6 74.3 103.6 30.7 15.1 79.8 99.1 4 31.9 14.5 76.3124.2 27.5 14.0 70.5 113.6 27.9 14.8 74.5 112.5 32.1 16.1 74.3 108.831.0 14.4 74.5 110.1 5 31.2 13.1 76.7 96.5 31.5 13.5 82.9 106.1 31.514.7 70.9 112.9 30.9 14.5 77.6 117.7 31.0 13.9 73.1 101.9 6 29.8 15.673.3 110.1 30.5 13.5 71.5 99.3 31.0 13.9 72.6 120.5 30.5 14.6 74.2 109.430.7 13.6 81.8 115.9 Avg 31.1 14.5 75.1 108.4 SD 1.5 1.0 3.6 6.9 CV %4.8 6.7 4.7 6.4

Example 9 Recovery Studies

Two recovery studies were performed. The first was performed using sixspecimens, spiked with two different concentrations each of 25OHD₂ and25OHD₃. These spiked specimens were subjected to the hybrid proteinprecipitation/liquid-liquid extraction procedure described in Example 1.Then, aliquots of the extracts of the spiked specimens were derivatizedwith normal PTAD, following the procedure discussed above, and analyzedin quadruplicate. The spiked concentrations were within the workablerange of the assay. The six pools yielded an average accuracy of about89% at spiked levels of greater than about 44 ng/mL and about 92% atspiked levels of greater than about 73 ng/mL. Only two of the 24experimental recoveries were less than 85%; the remaining 22 assays werewithin the acceptable accuracy range of 85-115%. The results of thespiked specimen recovery studies are presented in Table 9, below.

TABLE 9 Spiked Specimen Recovery Studies 25OHD₂ 25OHD₃ Pool Spike Levelng/mL (% Recovery) ng/mL (% Recovery) 1 — 12.0 — 10.8 — 44 ng/mL 25OHD₂48.0 81.2 10.7 — 73 ng/mL 25OHD₂ 79.0 91.6 10.7 — 44 ng/mL 25OHD₃ 12.7 —51.9 92.9 73 ng/mL 25OHD₃ 11.5 — 76.5 89.9 2 — 11.9 — 10.8 — 44 ng/mL25OHD₂ 48.0 81.4 10.6 — 73 ng/mL 25OHD₂ 75.6 87.1 11.0 — 44 ng/mL 25OHD₃10.0 — 48.8 85.6 73 ng/mL 25OHD₃ 11.6 — 76.4 89.7 3 — 13.6 — 6 — 44ng/mL 25OHD₂ 52.5 87.8 10.9 — 73 ng/mL 25OHD₂ 76.8 86.4 10.5 — 44 ng/mL25OHD₃ 13.2 — 49.6 88.0 73 ng/mL 25OHD₃ 12.3 — 78.0 92.2 4 — 9.0 — 12.7— 44 ng/mL 25OHD₂ 50.3 93.1 13.5 — 73 ng/mL 25OHD₂ 77.6 93.8 13.2 — 44ng/mL 25OHD₃ 10.0 — 52.1 89.0 73 ng/mL 25OHD₃ 9.5 — 83.6 97.0 5 — 21.8 —14.0 — 44 ng/mL 25OHD₂ 68.0 104.2 13.3 — 73 ng/mL 25OHD₂ 91.1 94.8 13.6— 44 ng/mL 25OHD₃ 23.3 — 53.5 89.1 73 ng/mL 25OHD₃ 22.2 — 86.4 99.1 6 —13.8 — 9.3 — 44 ng/mL 25OHD₂ 50.6 83.0 9.2 — 73 ng/mL 25OHD₂ 83.9 95.99.5 — 44 ng/mL 25OHD₃ 13.5 — 48.6 88.6 73 ng/mL 25OHD₃ 13.2 — 76.5 91.9

The second recovery study was performed again using six specimens. Ofthese six specimens, three had high endogenous concentration of 25OHD₂and three had high endogenous concentrations of 25OHD₃. The specimenswere paired and mixed at ratios of about 4:1, 1:1, and 1:4. Theresulting mixtures were subjected to the hybrid proteinprecipitation/liquid-liquid extraction procedure described in Example 1.Then, aliquots of the extracts of the mixed specimens were derivatizedwith normal PTAD, following the procedure discussed above, and analyzedin quadruplicate. These experiments yielded an average accuracy of about98% for 25OHD₂ and about 93% for 25OHD₃. All individual results werewithin the acceptable accuracy range of 85-115%. The results of themixed specimen recovery studies are presented in Table 10, below.

TABLE 10 Mixed Specimen Recovery Studies 25OHD₂ 25OHD₃ Meas- Ex- Re-Meas- Ex- Re- Specimen ured pected covery ured pected covery Mixtureng/mL ng/mL (%) ng/mL ng/mL (%) 100% A 45.2 — — 5.5 — — 4:1 A:B 37.137.0 100 11.6 13.1 88 1:1 A:B 26.4 24.6 107 24.4 24.4 100 1:4 A:B 12.612.3 102 33.9 35.7 95 100% B 4.1 — — 43.3 — — 100% C 46.8 — — 8.3 — —4:1 C:D 38.1 38.7 98 17.7 18.3 97 1:1 C:D 25.0 26.6 94 32.0 33.4 96 1:4C:D 14.4 14.4 100 46.5 48.4 96 100% D 6.3 — — 58.5 — — 100% E 38.7 — —7.4 — — 4:1 E:F 33.4 34.3 97 15.7 17.5 89 1:1 E:F 27.1 27.7 98 27.8 32.685 1:4 E:F 18.3 21.0 87 44.0 47.7 92 100% F 16.6 — — 57.8 — — *Measuredvalues are averages of analysis of four aliquots.

Example 10 Method Correlation Study

The method of detecting vitamin D metabolites followingPTAD-derivatization was compared to a mass spectrometric method in whichthe vitamin D metabolites are not derivatized prior to analysis. Such amethod is described in the published U.S. Patent Application2006/0228808 (Caulfield, et al.). Eight specimens were split andanalyzed according to both methods. The correlation between the twomethods was assessed with linear regression, deming regression, andBland-Altman analysis for complete data sets (including calibrationsamples, QC pools, and unknowns), as well as for unknowns only.

Plots of the linear regression analysis and the Deming regressionanalysis are shown in FIGS. 4A-B (for 25OHD₂) and FIGS. 5A-B (for25OHD₃).

Example 11 Hemolysis, Lipemia, and Icteria Studies

The effect hemolysis, lipemia, and icteria have on the assay was alsoinvestigated.

Hemolysis.

The effect of hemolysis was evaluated by pooling patient samples withknown endogenous concentrations of both 25OHD₂ and 25OHD₃ to create fivedifferent pools with concentrations across the dynamic range of theassay. Then, lysed whole blood was spiked into the pools to generatelightly and moderately hemolyzed samples.

The lightly and moderately hemolyzed samples were analyzed inquadruplicate and the results were compared to levels of samples withoutwhole blood spikes. The resulting comparison indicated a % difference ofless than 15% for both 25OHD₂ and 25OHD₃. Therefore, light to moderatelyhemolyzed specimens are acceptable for analysis.

Lipemia.

The effect of lipemia was evaluated by pooling patient samples withknown endogenous concentrations of both 25OHD₂ and 25OHD₃ to create fivedifferent pools with concentrations across the dynamic range of theassay. Then, powdered lipid extract was added to the pools to generatelightly and grossly lipemic specimens. Specimens were run inquadruplicate and results were compared to the non-lipemic pool resultand the accuracy was calculated. The data shows that determination of25OHD₂ is unaffected by lipemia (all values were within an acceptableaccuracy range of 85-115%), however, 25OHD₃ is affected by lipemia,resulting in determination in lower than expected values. The degree ofvariance increased with the degree of lipemia. Therefore, light but notgrossly lipemic specimens are acceptable.

Icteria.

The effect of icteria was evaluated by pooling patient samples withknown endogenous concentrations of both 25OHD₂ and 25OHD₃ to create fivedifferent pools with concentrations across the dynamic range of theassay. Then, a concentrated solution of Bilirubin was spiked into thepools to generate lightly and grossly icteric specimens. Specimens wererun in quadruplicate and results were compared to the non-icteric poolresult and the accuracy was calculated. The data showed that 25OHD₂ and25OHD₃ are unaffected by icteria (with all values within an acceptableaccuracy range of 85-115%). Therefore, icteric specimens are acceptable.

Example 12 Injector Carryover Studies

Blank matrices were run immediately after a specimen with a highconcentration of 25OHD₂ and 25OHD₃ in order to evaluate carryoverbetween samples. These studies indicated that the response at theretention time of analyte or internal standard was not large enough tocompromise the integrity of the assay. Data from these studies ispresented in Table 11, below.

TABLE 11 Injector Carryover Study Results Specimen 25OHD₂ 25OHD₃Injection Type (ng/mL) (ng/mL) 1 Blank 0.9 1.6 2 High 292.6 356.8 3Blank 1.0 0.9 4 Blank −0.1 0.5 5 High 290.1 360.1 6 High 299.9 350.5 7Blank 1.0 1.5 8 Blank 0.6 1.4 9 Blank 1.3 1.4 10 High 285.8 352.1 11High 303.1 312.1 12 High 293.8 295.1 13 Blank 0.9 0.8 14 Blank 1.0 1.815 Blank 1.1 1.4 16 Blank 1.0 1.6 17 High 291.7 371.6 18 High 334.2360.1 19 High 301.7 328.5 20 High 283.1 382.1 21 Blank 0.6 1.1 22 Blank0.6 1.3 23 Blank 0.7 1.4 24 Blank 0.4 1.9 25 Blank 0.4 0.9 26 High 300.7311.7 27 High 279.5 302.0 28 High 317.5 341.0 29 High 261.5 403.4 30High 288.3 362.6 31 Blank 2.7 1.6 32 Blank 1.7 1.2 33 Blank 0.5 1.3 34Blank 1.3 1.7 35 Blank 0.3 1.6 36 Blank 0.6 1.4 37 High 311.7 366.2 38High 314.1 342.0 39 High 325.7 349.1 40 High 289.6 326.6 41 High 291.5322.3 42 High 278.9 336.5 43 Blank 2.1 2.5 44 Blank 0.6 1.6 45 Blank 0.71.4 46 Blank 0.7 1.5 47 Blank 0.1 1.0 48 Blank 0.7 1.1 49 Blank 1.3 1.050 High 281.2 345.6 51 High 312.5 348.3 52 High 304.8 329.1 53 High290.5 353.9 54 High 286.4 344.9 55 High 302.5 330.6 56 High 292.2 388.557 Blank 0.8 1.5 58 Blank 1.3 1.4 59 Blank 3.5 2.6 60 Blank 0.4 1.8 61Blank 1.0 1.4 62 Blank 1.0 1.2 63 Blank 0.7 1.0 64 Blank 1.1 1.4 65 High285.4 355.4 66 High 318.0 355.0 67 High 285.5 345.7 68 High 303.0 317.169 High 276.3 351.4 70 High 321.8 350.4 71 High 279.4 329.6 72 High299.1 337.9 73 Blank 0.9 1.6 74 Blank 1.7 1.6 75 Blank 1.0 1.1 76 Blank1.8 2.7 77 Blank 1.0 1.9 78 Blank 0.6 1.1 79 Blank 0.9 0.9 80 Blank 1.22.2

Example 13 Suitable Specimen Types

The assay was conducted on various specimen types. Human serum andGel-Barrier Serum (i.e., serum from Serum Separator Tubes), as well asEDTA Plasma and Heparin were established as acceptable sample types. Inthese studies, sets of human serum (serum), Gel-Barrier Serum (SST),EDTA Plasma (EDTA), and heparin (Na Hep) drawn at the same time from thesame patient were tested for 25OHD₂ (40 specimen sets) and 25OHD₃ (6specimen sets). Due to the limitations with clot detection/sensing inexisting automated pipetting systems, plasma was not tested forautomated procedures.

The results of the specimen type studies are presented in Tables 12A andB for 25OHD₂ and 25OHD₃, respectively.

TABLE 12A Results from Specimen Type Studies for 25OHD₂ MeasuredConcentration 25OHD₂ (ng/mL) Specimen Set CC ID # Serum SST EDTA Na Hep1 5804 26.8 25.7 24.3 26.8 2 5207 16.1 17.6 16.1 16.5 3 5235 17.4 17.716.8 17.2 4 5333 62.9 62.7 63.7 57.4 5 5336 33.0 32.4 28.8 28.8 6 533917.2 17.6 17.8 17.8 7 5340 16.7 17.1 16.8 16.5 8 5342 28.6 27.9 26.930.5 9 5344 23.3 23.8 22.3 22.9 10 5351 19.4 20.0 20.4 21.4 11 5355 17.616.7 19.4 18.3 12 5362 25.3 25.2 23.5 24.0 13 5365 40.9 44.7 46.8 42.914 5406 23.1 20.3 21.5 20.5 15 5408 31.7 33.9 31.6 32.3 16 5414 21.121.8 21.2 20.4 17 5422 44.0 47.7 45.5 47.3 18 5432 13.6 14.2 12.3 13.819 5463 15.1 15.4 15.6 14.5 20 5493 38.6 42.2 40.1 36.8 21 5366 47.548.1 46.7 45.1 22 5368 23.0 23.6 22.3 22.3 23 5392 34.1 33.4 34.4 27.624 5451 36.4 42.1 40.0 38.3 25 5455 27.3 29.9 25.1 27.9 26 5476 16.717.9 15.8 16.6 27 5483 30.4 28.2 26.5 28.1 28 5484 38.2 37.7 37.2 36.029 5537 30.5 30.3 27.2 27.0 30 5547 9.2 9.0 8.7 8.2 31 5560 9.4 10.9 9.88.6 32 5571 30.9 31.7 29.6 29.2 33 5572 47.6 50.3 47.7 48.6 34 5577 11.211.7 10.4 9.2 35 5606 39.3 38.8 41.0 37.7 36 5611 21.9 25.3 20.7 21.1 375650 38.0 34.3 34.6 36.2 38 5651 34.8 32.8 32.4 32.4 39 5653 29.4 32.328.1 27.0 40 5668 11.4 12.8 14.2 13.1

TABLE 12B Results from Specimen Type Studies for 25OHD₃ Specimen CCMeasured Concentration 25OHD₃ (ng/mL) Set ID # Serum SST EDTA Na Hep 25207 6.6 6.9 7.1 7.2 6 5339 5.8 5.2 4.5 5.6 11 5355 7.8 8.2 8.8 8.2 205493 3.9 4.2 4.3 4.2 37 5650 3.7 4.5 4.6 5.2 39 5653 4.7 5.1 4.6 4.7

Example 14 Multiplex Patient Samples with Multiple Derivatizing Agents

Patient sample multiplexing after derivatization with differentderivatizing agents was demonstrated in the following crossoverexperiments.

First, two patients samples (i.e., sample A and sample B) were bothsubjected to the hybrid protein precipitation/liquid-liquid extractionprocedure described in Example 1. Then, aliquots of the extracts fromsample A and sample B were derivatized with normal PTAD, following theprocedure discussed above. Second aliquots of the extracts from sample Aand sample B were also derivatized with ¹³C₆-PTAD, also according to theprocedure discussed above.

After the four derivatization reactions were quenched, a portion of thePTAD-derivatized sample A was mixed with ¹³C₆-PTAD-derivatized sample B,and a portion of ¹³C₆-PTAD-derivatized sample A was mixed withPTAD-derivatized sample B.

These mixtures were loaded onto a 96-well plate and analyzed accordingto the liquid chromatography-mass spectrometry methods described inExamples 2 and 3. Again, 25OHD₂-[6, 19, 19]-²H₃ and 25OHD₃-[6, 19,19]-²H₃ were used as internal standards (shown in Table 13, below, as25OHD₂-IS and 25OHD₃-IS). The mass spectrometer was programmed tomonitor for the PTAD- and ¹³C₆-PTAD-derivatized vitamin D metaboliteconjugates shown in Table 13. The indicated mass transitions are notmeant to be limiting in any way. As seen in the Examples that follow,other mass transitions could be selected for each analyte to generatequantitative data.

TABLE 13 Ions monitored for mass spectrometric determination ofmultiplex PTAD- and ¹³C₆-PTAD-derivatized samples (by MRM). AnalytePrecursor Fragment PTAD—25OHD₃ 558 298 PTAD—25OHD₃—IS 561 301PTAD—25OHD₂ 570 298 PTAD—25OHD₂—IS 573 301 ¹³C_(6—)PTAD—25OHD₃ 564 304¹³C_(6—)PTAD—25OHD₃—IS 567 307 ¹³C_(6—)PTAD—25OHD₂ 576 304¹³C_(6—)PTAD—25OHD₂—IS 579 307

Derivatized samples A and B and permutations of mixtures of the twodescribed above were analyzed and plotted to evaluate goodness of fit ofthe data. These results are presented in FIGS. 6A-D, 7A-D, and 8A-D.

FIGS. 6A-D are plots comparing the results of analysis of multiplexsamples and unmixed samples (with the same derivatization agent). Theseplots show R² values in excellent agreement (i.e., R² values for allfour variants are in excess of 0.98). This shows that, given a constantderivatization agent, analysis of mixed samples gives the same result asanalysis of unmixed samples.

FIGS. 7A-D are plots comparing the results of analysis of the samespecimen treated with different derivatization agents (but comparingmixed versus mixed, or unmixed versus unmixed samples). These plots alsoshow R² values in excellent agreement (i.e., R² values for all fourvariants are in excess of 0.98). This shows that the isotopic variationbetween PTAD and ¹³C₆-PTAD is not a source of difference in theperformance of the assay, at least when the compared samples are bothmixed, or unmixed.

FIGS. 8A-D are plots comparing the results of analysis of the samespecimen treated with different derivatization agents, with one analysiscoming from a mixed sample and one coming from an unmixed sample. Theseplots also show R² values in excellent agreement (i.e., R² values forall four variants are in excess of 0.99). This shows that the isotopicvariation between PTAD and ¹³C₆-PTAD in combination with variationbetween mixed and unmixed samples is not a source of difference in theperformance of the assay.

Thus, isotopic variation of the PTAD derivatization agent made nomeaningful difference even when samples were mixed together andintroduced into the mass spectrometer as a single injection.Multiplexing of patient samples was successfully demonstrated.

Example 15 Exemplary Spectra from LDTD-MS/MS Analysis of Native and PTADDerivatized 25-Hydroxyvitamin D₂ and 25-Hydroxyvitamin D₃

Underivatized and PTAD derivatized 25-hydroxyvitamin D₂ and25-hydroxyvitamin D₃ were analyzed by LDTD-MS/MS. Results of theseanalyses are presented below.

Exemplary Q1 scan spectra from analysis of 25-hydroxyvitamin D₂ and25-hydroxyvitamin D₃ are shown in FIGS. 9A and 10A, respectively. Thesespectra were collected by scanning Q1 across a m/z range of about 350 to450.

Exemplary product ion scans from each of these species are presented inFIGS. 9B and 10B, respectively. The precursor ions selected in Q1, andcollision energies used in fragmenting the precursors are indicated inTable 14.

A preferred MRM transition for the quantitation of 25-hydroxyvitamin D₂is fragmenting a precursor ion with a m/z of about 395.2 to a production with a m/z of about 208.8 or 251.0. A preferred MRM transition forthe quantitation of 25-hydroxyvitamin D₃ is fragmenting a precursor ionwith a m/z of about 383.2 to a product ion with a m/z of about 186.9 or257.0. However, as can be seen in the product ion scans in FIGS. 9B and10B, additional product ions may be selected to replace or augment thepreferred fragment ion.

TABLE 14 Precursor Ions and Collision Cell Energies for Fragmentation of25-hydroxyvitamin D₂ and 25-hydroxyvitamin D₃ Precursor Ion CollisionCell Energy Analyte (m/z) (V) 25-hydroxyvitamin D₂ 395.2 2025-hydroxyvitamin D₃ 383.2 20

Exemplary Q1 scan spectra from the analysis of samples containingPTAD-25-hydroxyvitamin D₂ and PTAD-25-hydroxyvitamin D₃ are shown inFIGS. 11A and 12A, respectively. These spectra were collected byscanning Q1 across a m/z range of about 520 to 620.

Exemplary product ion scans from each of these species are presented inFIGS. 11B and 12B, respectively. The precursor ions selected in Q1, andcollision energies used in fragmenting the precursors are indicated inTable 15.

A preferred MRM transition for the quantitation ofPTAD-25-hydroxyvitamin D₂ is fragmenting a precursor ion with a m/z ofabout 570.3 to a product ion with a m/z of about 298.1. A preferred MRMtransition for the quantitation of PTAD-25-hydroxyvitamin D₃ isfragmenting a precursor ion with a m/z of about 558.3 to a product ionwith a m/z of about 298.1. However, as can be seen in the product ionscans in FIGS. 11B and 12B, additional product ions may be selected toreplace or augment the preferred fragment ion.

TABLE 15 Precursor Ions and Collision Cell Energies for Fragmentation ofPTAD-25-hydroxyvitamin D₂ and PTAD-25-hydroxyvitamin D₃ Precursor IonCollision Cell Energy Analyte (m/z) (V) PTAD-25-hydroxyvitamin D₂ 570.315 PTAD-25-hydroxyvitamin D₃ 558.3 15

Example 16 Exemplary Spectra from LDTD-MS/MS Analysis of PTADDerivatized 1α,25-Dihydroxyvitamin D₂ and 1α,25-Dihydroxyvitamin D₃

PTAD derivatives of 1α,25-dihydroxyvitamin D₂ and 1α,25-dihydroxyvitaminD₃ were prepared by treating aliquots of stock solutions of each analytewith PTAD in acetonitrile. The derivatization reactions was allowed toproceed for approximately one hour, and were quenched by adding water tothe reaction mixture. The derivatized analytes were then analyzedaccording to the LDTD-MS/MS procedure outlined above.

Exemplary Q1 scan spectra from the analysis of samples containingPTAD-1α,25-dihydroxyvitamin D₂ and PTAD-1α,25-hydroxyvitamin D₃ areshown in FIGS. 13A, and 14A, respectively. These spectra were collectedwith LDTD-MS/MS by scanning Q1 across a m/z range of about 520 to 620.

Exemplary product ion scans generated from three different precursorions for each of PTAD-1α,25-dihydroxyvitamin D₂ andPTAD-1α,25-hydroxyvitamin D₃ are presented in FIGS. 13B-D, and 14B-D,respectively. The precursor ions selected in Q1 and the collisionenergies used to generate these product ion spectra are indicated inTable 16.

Exemplary MRM transitions for the quantitation ofPTAD-1α,25-dihydroxyvitamin D₂ include fragmenting a precursor ion witha m/z of about 550.4 to a product ion with a m/z of about 277.9;fragmenting a precursor ion with a m/z of about 568.4 to a product ionwith a m/z of about 298.0; and fragmenting a precursor ion with a m/z ofabout 586.4 to a product ion with a m/z of about 314.2. Exemplary MRMtransitions for the quantitation of PTAD-1α,25-hydroxyvitamin D₃ includefragmenting a precursor ion with a m/z of about 538.4 to a product ionwith a m/z of about 278.1; fragmenting a precursor ion with a m/z ofabout 556.4 to a product ion with a m/z of about 298.0; and fragmentinga precursor ion with a m/z of about 574.4 to a product ion with a m/z ofabout 313.0. However, as can be seen in the product ion scans in FIGS.6B-D and 7B-D, several other product ions are generated uponfragmentation of the precursor ions. Additional product ions may beselected from those indicated in FIGS. 13B-D and 14B-D to replace oraugment the exemplary fragment ions.

TABLE 16 Precursor Ions and Collision Cell Energies for Fragmentation ofPTAD-1α,25-dihydroxyvitamin D₂ and PTAD-1α,25-dihydroxyvitamin D₃ Energyof Precursor Ion Collision Cell Analyte (m/z) (V)PTAD-1α,25-dihydroxyvitamin D₂ 550.4, 568.4, 15 586.4PTAD-1α,25-dihydroxyvitamin D₃ 538.4, 556.4, 15 574.4

PTAD derivatives of various deuterated forms of dihydroxyvitamin Dmetabolites were also investigated. PTAD derivatives of1α,25-dihydroxyvitamin D₂-[26, 26, 26, 27, 27, 27]- ²H₆,1α,25-dihydroxyvitamin D₃-[6, 19, 19]-²H₃, and 1α,25-dihydroxyvitaminD₃-[26, 26, 26, 27, 27, 27]-²H₆ were prepared and analyzed as above.

Exemplary MRM transitions for the quantitation ofPTAD-1α,25-dihydroxyvitamin D₂-[26, 26, 26, 27, 27, 27]-²H₆ includefragmenting a precursor ion with a m/z of about 556.4 to a product ionwith a m/z of about 278.1; fragmenting a precursor ion with a m/z ofabout 574.4 to a product ion with a m/z of about 298.1; and fragmentinga precursor ion with a m/z of about 592.4 to a product ion with a m/z ofabout 313.9.

Exemplary MRM transitions for the quantitation ofPTAD-1α,25-dihydroxyvitamin D₃-[6, 19, 19]-²H₃ include fragmenting aprecursor ion with a m/z of about 541.4 to a product ion with a m/z ofabout 280.9; fragmenting a precursor ion with a m/z of about 559.4 to aproduct ion with a m/z of about 301.1; and fragmenting a precursor ionwith a m/z of about 577.4 to a product ion with a m/z of about 317.3.Exemplary MRM transitions for the quantitation ofPTAD-1α,25-dihydroxyvitamin D₂-[26, 26, 26, 27, 27, 27]-²H₆ includefragmenting a precursor ion with a m/z of about 544.4 to a product ionwith a m/z of about 278.0; fragmenting a precursor ion with a m/z ofabout 562.4 to a product ion with a m/z of about 298.2; and fragmentinga precursor ion with a m/z of about 580.4 to a product ion with a m/z ofabout 314.0.

Example 17 Exemplary Spectra from MS/MS Analysis of PTAD DerivatizedVitamin D₂ and Vitamin D₃

PTAD derivatives of vitamin D₂, and vitamin D₃ were prepared by treatingaliquots of stock solutions of each analyte with PTAD in acetonitrile.The derivatization reactions was allowed to proceed for approximatelyone hour, and were quenched by adding water to the reaction mixture. Thederivatized analytes were then analyzed by MS/MS.

Exemplary Q1 scan spectra from the analysis of samples containingPTAD-vitamin D₂, and PTAD-vitamin D₃ are shown in FIGS. 15A and 16A,respectively. These analyses were conducted by directly injectingstandard solutions containing the analyte of interest into a FinniganTSQ Quantum Ultra MS/MS system (Thermo Electron Corporation). A liquidchromatography mobile phase was simulated by passing 800 μL/min of 80%acetonitrile, 20% water with 0.1% formic acid through an HPLC column,upstream of introduction of the analyte. The spectra were collected byscanning Q1 across a m/z range of about 500 to 620.

Exemplary product ion scans generated from precursor ions for each ofPTAD-vitamin D₂ and PTAD-vitamin D₃ are presented in FIGS. 15B and 16B,respectively. The precursor ions selected in Q1 and the collisionenergies used to generate these product ion spectra are indicated inTable 17.

An exemplary MRM transition for the quantitation of PTAD-vitamin D₂includes fragmenting a precursor ion with a m/z of about 572.2 to aproduct ion with a m/z of about 297.9. An exemplary MRM transition forthe quantitation of PTAD-vitamin D₃ includes fragmenting a precursor ionwith a m/z of about 560.2 to a product ion with a m/z of about 298.0.However, as can be seen in the product ion scans in FIGS. 15B and 16B,several other product ions are generated upon fragmentation of theprecursor ions. Additional product ions may be selected from thoseindicated in FIGS. 15B and 16B to replace or augment the exemplaryfragment ions.

TABLE 17 Precursor Ions and Collision Cell Energies for Fragmentation ofPTAD-vitamin D₂ and PTAD-vitamin D₃ Precursor Ion Collision Cell EnergyAnalyte (m/z) (V) PTAD-vitamin D₂ 572.2 15 PTAD-vitamin D₃ 560.2 15

PTAD derivatives of various deuterated forms of vitamin D were alsoinvestigated. PTAD derivatives of vitamin D₂-[6, 19, 19]-²H₃, vitaminD₂-[26, 26, 26, 27, 27, 27]-²H₆, vitamin D₃-[6, 19, 19]-²H₃, and vitaminD₃-[26, 26, 26, 27, 27, 27]-²H₆ were prepared and analyzed as above.

An exemplary MRM transition for the quantitation of PTAD-vitamin D₂-[6,19, 19]-²H₃ includes fragmenting a precursor ion with a m/z of about575.2 to a product ion with a m/z of about 301.0. An exemplary MRMtransition for the quantitation of PTAD-vitamin D₂-[26, 26, 26, 27, 27,27]-²H₆ includes fragmenting a precursor ion with a m/z of about 578.2to a product ion with a m/z of about 297.9.

An exemplary MRM transition for the quantitation of PTAD-vitamin D₃-[6,19, 19]-²H₃ includes fragmenting a precursor ion with a m/z of about563.2 to a product ion with a m/z of about 301.0. An exemplary MRMtransition for the quantitation of PTAD-vitamin D₃-[26, 26, 26, 27, 27,27]-²H₆ includes fragmenting a precursor ion with a m/z of about 566.2to a product ion with a m/z of about 298.0.

The contents of the articles, patents, and patent applications, and allother documents and electronically available information mentioned orcited herein, are hereby incorporated by reference in their entirety tothe same extent as if each individual publication was specifically andindividually indicated to be incorporated by reference. Applicantsreserve the right to physically incorporate into this application anyand all materials and information from any such articles, patents,patent applications, or other physical and electronic documents.

The methods illustratively described herein may suitably be practiced inthe absence of any element or elements, limitation or limitations, notspecifically disclosed herein. Thus, for example, the terms“comprising”, “including,” containing”, etc. shall be read expansivelyand without limitation. Additionally, the terms and expressions employedherein have been used as terms of description and not of limitation, andthere is no intention in the use of such terms and expressions ofexcluding any equivalents of the features shown and described orportions thereof. It is recognized that various modifications arepossible within the scope of the invention claimed. Thus, it should beunderstood that although the present invention has been specificallydisclosed by preferred embodiments and optional features, modificationand variation of the invention embodied therein herein disclosed may beresorted to by those skilled in the art, and that such modifications andvariations are considered to be within the scope of this invention.

The invention has been described broadly and generically herein. Each ofthe narrower species and subgeneric groupings falling within the genericdisclosure also form part of the methods. This includes the genericdescription of the methods with a proviso or negative limitationremoving any subject matter from the genus, regardless of whether or notthe excised material is specifically recited herein.

Other embodiments are within the following claims. In addition, wherefeatures or aspects of the methods are described in terms of Markushgroups, those skilled in the art will recognize that the invention isalso thereby described in terms of any individual member or subgroup ofmembers of the Markush group.

What is claimed is:
 1. A method for determining the amount of asteroidal compound in each of a plurality of test samples with a singlemass spectrometric assay, wherein the steroidal compound prior toprocessing is the same in each test sample, the method comprising:processing a plurality of test samples differently to form a pluralityof processed samples, wherein said processing comprises subjecting eachtest sample to a different Cookson-type derivatizing agent underconditions suitable to generate Cookson-type derivatized steroidalcompounds, and wherein as a result of said processing, the steroidalcompound in each processed sample is distinguishable by massspectrometry from the steroidal compound in other processed samples;combining the processed samples to form a multiplex sample; subjectingthe multiplex sample to an ionization source under conditions suitableto generate one or more ions detectable by mass spectrometry, whereinone or more ions generated from the steroidal compound from eachprocessed sample are distinct from one or more ions from the steroidalcompound from the other processed samples; detecting the amount of oneor more ions from the steroidal compound from each processed sample bymass spectrometry; and relating the amount of one or more ions from thesteroidal compound from each processed sample to the amount of thesteroidal compound in each test sample.
 2. The method of claim 1,wherein said plurality of processed samples comprises one processedsample with underivatized steroidal compounds.
 3. The method of claim 1,wherein said different derivatizing agents are isotopic variants of eachanother.
 4. The method of claim 1, wherein said Cookson-typederivatization agents are selected from the group consisting of4-phenyl-1,2,4-triazoline-3,5-dione (PTAD),4-methyl-1,2,4-triazoline-3,5-dione (MTAD),4-[2-(6,7-dimethoxy-4-methyl-3-oxo-3,4-dihydroquinoxalyl)ethyl]-1,2,4-triazoline-3,5-dione(DMEQTAD), 4-(4-nitrophenyl)-1,2,4-triazoline-3,5-dione (NPTAD),4-ferrocenylmethyl-1,2,4-triazoline-3,5-dione (FMTAD), and isotopicvariants thereof.
 5. The method of claim 1, wherein said Cookson-typederivatizing agents are isotopic variants of4-phenyl-1,2,4-triazoline-3,5-dione (PTAD).
 6. The method of claimsclaim 1, wherein the plurality of samples comprises two samples, a firstderivatizing reagent is 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD), anda second derivatizing reagent is¹³C₆-4-phenyl-1,2,4-triazoline-3,5-dione (¹³C₆-PTAD).
 7. The method ofclaim 1, wherein said steroidal compound is a vitamin D or vitamin Drelated compound.
 8. The method of claim 1, wherein said steroidalcompound is selected from the group consisting of vitamin D₂, vitaminD₃, 25-hydroxyvitamin D₂ (25OHD₂), 25-hydroxyvitamin D₃ (25OHD₃),1α,25-dihydroxyvitamin D₂ (1α,25OHD₂), and 1α,25-dihydroxyvitamin D₃(1α,25OHD₃).
 9. The method of claim 8, wherein said steroidal compoundis 25-hydroxyvitamin D₂ (25OHD₂) or 25-hydroxyvitamin D₃ (25OHD₃). 10.The method of claim 1, further comprising subjecting the multiplexsample to an extraction column and an analytical column prior tosubjecting to an ionization source.
 11. The method of claim 10, whereinthe extraction column is a solid-phase extraction (SPE) column.
 12. Themethod of claim 10, wherein the extraction column is a turbulent flowliquid chromatography (TFLC) column.
 13. The method of claim 10, whereinthe analytical column is a high performance liquid chromatography (HPLC)column.
 14. The method of claim 1, wherein mass spectrometry is tandemmass spectrometry.
 15. The method of claim 14, wherein said tandem massspectrometry is conducted as multiple reaction monitoring, precursor ionscanning, or product ion scanning.
 16. The method of claim 10, whereinthe extraction column, analytical column, and the ionization source areconnected in an on-line fashion.
 17. The method of claim 1, wherein saidionization source comprises laser diode thermal desorption (LDTD). 18.The method of claim 1, wherein said ionization source comprises anelectrospray ionization source (ESI) or an atmospheric pressure chemicalionization source (APCI).
 19. The method of claim 1, wherein said testsamples comprise biological samples.
 20. The method of claim 19, whereinsaid test samples comprise plasma or serum. 21.-58. (canceled)